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Published on: September 7, 2022
Pubic/ischial stress fractures after eccentric rotational acetabular osteotomy
Masaki Tsuboi1, Yukiharu Hasegawa, Kanji Fujita
1Department of Orthopaedic Surgery, Aichi-ken Saiseikai Hospital, 1-1-18 Sakou, Nishi-ku, Nagoya, 451-0052, Japan. m.tsuboi@yoshida-seikei.jp
Summary
Pubic/ischial stress fractures are a rare complication after eccentric rotational acetabular osteotomy (ERAO), particularly in women. However, these fractures do not impact long-term clinical outcomes.
Area of Science:
- Orthopedic Surgery
- Musculoskeletal Research
- Reconstructive Surgery
Background:
- Complications following periacetabular osteotomy are documented, yet stress fractures of the pubic and ischial bones are less recognized.
- Eccentric rotational acetabular osteotomy (ERAO) is a surgical procedure for hip conditions.
Purpose of the Study:
- To determine the incidence of pubic/ischial stress fractures after ERAO.
- To identify factors associated with these fractures.
- To evaluate treatment outcomes for pubic/ischial stress fractures post-ERAO.
Main Methods:
- A retrospective analysis of 340 hips (290 patients) who underwent ERAO with at least 1 year of follow-up.
- Investigated factors including demographics, osteoarthritis severity, radiographic parameters (e.g., CE angle), and pubic discontinuity.
- Compared patients with and without pubic/ischial stress fractures.
Main Results:
- 10 hips (2.9%) developed pubic/ischial stress fractures, exclusively in female patients (mean age 47).
- Pubic discontinuity was a significant predictor for stress fracture development (P < 0.0001).
- Fractures occurred within 3 months post-surgery, with bony union achieved in all cases; recurrence was rare.
Conclusions:
- Patients with pubic discontinuities exhibit increased susceptibility to pubic/ischial stress fractures after ERAO.
- The occurrence of a pubic/ischial stress fracture did not negatively affect the final clinical outcomes.
