Polygonal triple (Kotz) osteotomy (over 10 years experience)

Area of Science:

• Orthopedic Surgery
• Hip Reconstruction
• Acetabular Dysplasia Treatment

Background:

• Acetabular dysplasia is a condition requiring surgical intervention for optimal hip joint function.
• Polygonal triple (Kotz) osteotomy is a surgical technique used to address acetabular dysplasia.

Purpose of the Study:

• To evaluate the long-term clinical and radiological outcomes of the Kotz osteotomy for acetabular dysplasia.
• To compare the results of the original Kotz osteotomy with a modified intra-pelvic approach.

Main Methods:

• A retrospective study of 31 hips in 27 patients undergoing Kotz osteotomy for acetabular dysplasia.
• Patients were divided into two groups: original Kotz osteotomy (Group I) and modified intra-pelvic Kotz osteotomy (Group II).
• Clinical (Trendelenburg gait, Harris Hip Score) and radiological (CE angle, VCE, Sharp angle) assessments were performed.

Main Results:

• Both surgical techniques demonstrated significant improvements in radiological parameters (CE angle, VCE, Sharp angle) postoperatively (P<0.05).
• The Harris Hip Score improved in all patients across both groups.
• The modified Kotz osteotomy showed a lower incidence of Trendelenburg gait and earlier recovery of abductor muscle strength compared to the original technique.

Conclusions:

• The Kotz osteotomy, in both its original and modified forms, is an effective treatment for acetabular dysplasia, leading to adequate acetabular coverage and high patient satisfaction.
• The modified intra-pelvic Kotz osteotomy offers advantages in early postoperative abductor muscle function and a reduced rate of Trendelenburg gait compared to the original procedure.