Objective: The aim of this study was to assess clinical and radiological results of incomplete triple pelvicosteotomy in acetabular dysplasia.Patients and methods: Twenty-six hips of 24 patients (5 males, 19 females) treated with incomplete triplepelvic osteotomy by a single surgeon from February 1995 to October 2001 were retrospectively reviewedat an average follow-up time of 12 years. The mean age at the time of surgery was 21.6 years (range: 14e41). Radiological evaluation was based on the central edge angle, acetabular angle, acetabular index,acetabular head index and lateralisation. Clinical and radiological scoring was performed using the Harrisscoring system, €Omero glu scoring system and the T€onnis criteria for osteoarthritis.Results: There was signiŞcant improvements in all of the radiological parameters with 88.5% goodradiological results, 96.2% excellent clinical results, no signiŞcant progression to osteoarthritis and noneed for conversion to total hip arthroplasty. The rate of major complication was 11%. Retroversion wasseen in 15.4% of the hips.Conclusion: Our results support the use of incomplete triple pelvic osteotomy as a safe choice in thetreatment of acetabular dysplasia as it offers clinical and radiological beneŞts and contributes to theprevention of osteoarthritis.Level of evidence: Level IV, therapeutic study.
1. Eren A, Omeroglu H, Güven M, Ugutmen E, Alt € ıntas¸ F. Incomplete triple pelvic osteotomy for the surgical treatment of dysplasia of the hip in adolescents and adults. J Bone Jt Surg. 2005;87-B(6):790e795.
2. Eren A, Ugutmen E. Osteotomies for acetabular dysplasia in adults and adolescents. Acta Orthop Traumatol Turc. 2007;41(Suppl. 1):74e79.
3. Steel HH. Triple osteotomy of the innominate bone. J Bone Jt Surg Am. 1973;55- A(2):343e350.
4. Kotz R, Da Vid T, Helwig U, Uyka D, Wanivenhaus A, Windhager R. Polygonal triple osteotomy of the pelvis. A correction for dysplastic hip joints. Int Orthop. 1992;16(4):311e316.
5. Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop Relat Res. 1988;232:26e36.
6. Ninomiya S, Tagawa H. Rotational acetabular osteotomy for the dysplastic hip. J Bone Jt Surg. 1984;66-A(3):430e436.
7. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Parths HV Acta Chir Scand. 1939;58(Suppl.):7e38.
8. Sharp IK. Acetabular dyslasia. The acetabular angle. J Bone Jt Surg. 1961;43-B: 268e272.
9. Tonnis D. € Congenital Dysplasia and Dislocation of the Hip in Children and Adults. 1st ed. New York: Springer; 1987, 113-30,167,370e380.
10. Heyman CH, Herndon CH. Legg-Perthes disease: a method for the measurement of roentgenographic result. J Bone Jt Surg. 1950;32-A:767e778.
11. Omeroglu H, Uçar DH, Tümer T. A new, objective radiographic classi € fication system for the assessment of treatment results in developmental dysplasia of the hip. J Pediatr Orthop B. 2006;15(2):77e82.
12. Harris HW. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Jt Surg. 1969;51-A:737e755.
13. De Kleuver M, Kooijman MAP, Pavlov PW, Veth RPH. Triple osteotomy of the pelvis for acetabular dysplasia: results at 8 to 15 years. J Bone Jt Surg. 1997;79- B(2):225e229.
14. Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466(7): 1633e1644.
15. Siebenrock KA, Leunig M, Ganz R. Periacetabular osteotomy: the Bernese experience. Instr Course Lect. 2001;50:239e245.
16. Hasegawa Y, Masui T, Yamaguchi J, Kawabe K, Suzuki S. Factors leading to osteoarthritis after eccentric rotational acetabular osteotomy. Clin Orthop Relat Res. 2007;459:207e215.
17. Nozawa M, Maezawa K, Matsuda K, Kim S, Shitoto K, Kurosawa H. Rotational acetabular osteotomy for advanced osteoarthritis of the hip joint with acetabular dysplasia. Int Orthop. 2009;33(6):1549e1553.
18. Tsumura H, Kaku N, Ikeda S, Torısu T. A computer simulation of rotational acetabular osteotomy for dysplastic hip joint: does the optimal transposition of the acetabular fragment exist? J Orthop Sci. 2005;10(2):145e151.
19. Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Jt Surg. 2003;85-A(2):278e286.
20. Ziebarth K, Balakumar J, Domayer S, Kim YJ, Millis MB. Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after bernese periacetabular osteotomy? Clin Orthop Relat Res. 2011;469(2):447e453.
21. Alberts CE, Steppacher SD, Ganz R, Tannast M, Siebenrock KA. Impingement adversely affects 10-year survivorship after periacetabular osteotomy for DDH. Clin Orthop Relat Res. 2013;471(5):1602e1614.
22. Tannast M, Pfander G, Steppacher SD, Mast JW, Ganz R. Total acetabular retroversion following pelvic osteotomy: presentation, management, and outcome. Hip Int. 2013;23(Suppl. 9):14e26.
23. Ganz R. Further opinion. J Bone Jt Surg Br; 2005. http://dx.doi.org/10.1302/ 0301-620x.87b6.16800. http://web.jbjs.org.uk/cgi/data/87-B/6/790/DC1/1.