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Periacetabular osteotomy in patients with Down's syndrome
D A Katz1, Y-J Kim, M B Millis
1Department of Orthopaedic Surgery, Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA. katzdortho@aol.com
The Journal of Bone and Joint Surgery. British Volume
|March 30, 2005
Summary
A modified Bernese periacetabular osteotomy successfully treated acetabular dysplasia in patients with Down syndrome. This surgical technique improved hip stability and clinical outcomes in the study group.
Area of Science:
- Orthopedic surgery
- Genetics
- Pediatric orthopedics
Background:
- Acetabular dysplasia is a common hip condition.
- Patients with Down syndrome often present with hip abnormalities.
- Surgical intervention may be necessary to improve hip stability and function.
Purpose of the Study:
- To evaluate the efficacy of a modified Bernese periacetabular osteotomy.
- To assess the surgical outcomes in skeletally mature patients with Down syndrome and acetabular dysplasia.
Main Methods:
- A modified Bernese periacetabular osteotomy was performed on eight dysplastic acetabula in six patients with Down syndrome.
- Patients were followed for a mean of five years.
- Pre- and post-operative radiographic measurements (Tonnis acetabular angle, centre-edge angle, extrusion index) were analyzed.
Main Results:
- Significant improvements were observed in acetabular angle, centre-edge angle, and extrusion index post-operatively.
- Eight hips remained clinically stable with symptomatic improvement.
- Two patients required secondary surgery for subluxation, and one developed a labral tear.
Conclusions:
- The modified Bernese periacetabular osteotomy is a successful treatment option for acetabular dysplasia in Down syndrome patients.
- The procedure can lead to improved hip stability and function.
- Careful post-operative monitoring is essential to identify and manage potential complications.