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Long-term experience with Chiari's osteotomy.

Rainer Kotz1, Catharina Chiari, Jochen G Hofstaetter

  • 1Department of Orthopaedics, Medical University of Vienna, Währinger Gürtel 18-20, 1090, Vienna, Austria. rainer.kotz@meduniwien.ac.at

Clinical Orthopaedics and Related Research
|June 13, 2009
PubMed
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Chiari pelvic osteotomy shows good long-term function, with 40% of patients needing total hip arthroplasty after 32 years. Osteoarthritis progressed despite good functional scores in hips retained after the pelvic osteotomy procedure.

Area of Science:

  • Orthopedic surgery
  • Hip joint reconstruction
  • Osteoarthritis management

Background:

  • Chiari pelvic osteotomy is a surgical procedure for hip dysplasia.
  • Long-term outcomes and osteoarthritis progression after this procedure require further investigation.

Purpose of the Study:

  • To evaluate the long-term functional outcomes and radiographic osteoarthritis progression in patients who underwent Chiari pelvic osteotomy.
  • To determine the rate of conversion to total hip arthroplasty (THA) and factors influencing it.

Main Methods:

  • Retrospective case series of 66 patients (80 pelvic osteotomies) with minimum 27-year follow-up.
  • Analysis of functional hip scores (Harris hip score) and radiographic osteoarthritis grading.
  • Assessment of conversion rates to THA and correlation with age at surgery.

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Main Results:

  • 40% of hips underwent THA after an average of 26 years.
  • Hips not replaced had a median Harris hip score of 82.
  • Osteoarthritis progressed in native hips despite good functional scores.
  • Age at surgery was inversely correlated with the time to THA.

Conclusions:

  • Chiari pelvic osteotomy can provide good long-term function, but 40% require THA within 32 years.
  • Osteoarthritis progression is common even in hips retained after the procedure.
  • Age at osteotomy influences the timing of subsequent THA.