Clinical and radiological outcomes following surgical hip dislocation for paediatric hip pathologies, a prospective cohort study.


Journal

The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
ISSN: 1479-666X
Titre abrégé: Surgeon
Pays: Scotland
ID NLM: 101168329

Informations de publication

Date de publication:
Jun 2023
Historique:
received: 07 02 2022
accepted: 19 09 2022
medline: 10 5 2023
pubmed: 29 10 2022
entrez: 28 10 2022
Statut: ppublish

Résumé

Surgical Hip Dislocation (SHD) is a powerful tool in the armamentarium of any surgeon treating conditions affecting the hips of children presenting with sequelae of a number of common conditions including Legg-CalvéPerthes disease (LCPD) and slipped capital femoral epiphysis (SCFE). Risks associated with the procedure are well described. We investigated to assess if SHD is associated with significant surgical risk and if it improved clinical outcomes for patients. We conducted a prospective cohort study. We reviewed 18 (11 males and 7 females; mean age 13.7 years (6-17) with symptomatic hip pathology, secondary to femoroacetabular impingement (FAI) between 2017 and 2021. All patients underwent a surgical hip dislocation approach and femoral head-neck osteochondroplasty, Head Split osteotomy or both. Clinical improvement was assessed using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The minimum follow-up was 6 months (mean, 22 months; range, 6-42 months). WOMAC scores improved at final follow-up from 10 to 3 for pain, 33 to 10 for function, and 4 to 2 for the stiffness subscales. All radiographic measures improved significantly of the postoperative X-rays. No patients developed osteonecrosis, implant failure, deep infection, or nonunion. Surgical Hip Dislocation, in the short term, we found improvement in WOMAC scores and radiographic indices with a low complication rate.

Sections du résumé

BACKGROUND BACKGROUND
Surgical Hip Dislocation (SHD) is a powerful tool in the armamentarium of any surgeon treating conditions affecting the hips of children presenting with sequelae of a number of common conditions including Legg-CalvéPerthes disease (LCPD) and slipped capital femoral epiphysis (SCFE). Risks associated with the procedure are well described. We investigated to assess if SHD is associated with significant surgical risk and if it improved clinical outcomes for patients.
METHODS METHODS
We conducted a prospective cohort study. We reviewed 18 (11 males and 7 females; mean age 13.7 years (6-17) with symptomatic hip pathology, secondary to femoroacetabular impingement (FAI) between 2017 and 2021. All patients underwent a surgical hip dislocation approach and femoral head-neck osteochondroplasty, Head Split osteotomy or both. Clinical improvement was assessed using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index. The minimum follow-up was 6 months (mean, 22 months; range, 6-42 months).
RESULTS RESULTS
WOMAC scores improved at final follow-up from 10 to 3 for pain, 33 to 10 for function, and 4 to 2 for the stiffness subscales. All radiographic measures improved significantly of the postoperative X-rays. No patients developed osteonecrosis, implant failure, deep infection, or nonunion.
CONCLUSION CONCLUSIONS
Surgical Hip Dislocation, in the short term, we found improvement in WOMAC scores and radiographic indices with a low complication rate.

Identifiants

pubmed: 36307306
pii: S1479-666X(22)00115-9
doi: 10.1016/j.surge.2022.09.005
pii:
doi:

Types de publication

Review Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

198-202

Informations de copyright

Copyright © 2022 Royal College of Surgeons of Edinburgh (Scottish charity number SC005317) and Royal College of Surgeons in Ireland. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Disclosure of potential conflicts of interest No benefits in any form have been received or will be received from a commercial party related directly or indirectly to the subject of this article.

Auteurs

Shane Ahern (S)

Children's University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland.

Michael D O'Sullivan (MD)

Children's University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland; Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland. Electronic address: michaelosullivan86@gmail.com.

Kevin Clesham (K)

Children's University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland; Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland.

Anna Wade (A)

Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland.

Elizabeth Meleady (E)

Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland.

Connor Green (C)

Children's University Hospital, Temple St, Rotunda, Dublin 1, D01 XD99, Ireland; Cappagh Kids, National Orthopaedic Hospital Cappagh, Cappagh Rd, Cappoge, Dublin 11, D11 EV29 Ireland; UCD School of Medicine, University College Dublin, Belfield, Dublin 4 Ireland.

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Classifications MeSH