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Does shelf acetabuloplasty influence acetabular growth and remodeling?
Won Joon Yoo1, Hyuk Ju Moon, Tae-Joon Cho
1Division of Pediatric Orthopaedics, Seoul National University Children's Hospital, 101 Daehak-ro, Jongno-gu, Seoul 110-744, Korea.
Clinical Orthopaedics and Related Research
|November 4, 2011
Summary
Shelf acetabuloplasty generally stimulates acetabular growth in patients with Legg-Calvé-Perthes disease. However, residual acetabular dysplasia may persist, requiring careful consideration of surgical outcomes.
Area of Science:
- Orthopedic surgery
- Pediatric orthopedics
- Hip development
Background:
- Shelf acetabuloplasty is a surgical procedure for hip instability.
- Concerns exist regarding potential iatrogenic acetabular growth disturbances after surgery.
- Plain radiographs may not accurately reflect acetabular morphology, necessitating advanced imaging.
Purpose of the Study:
- To evaluate acetabular growth changes (stimulation or retardation) post-shelf acetabuloplasty using CT and radiography.
- To determine if femoral head deformity, subluxation, or acetabular dysplasia correlate with residual zonal rim dysplasia.
Main Methods:
- CT analysis and plain radiography were performed on 14 patients (mean age 9.3 years at surgery) 7 years post-operation.
- Radiographic indices of acetabular depth and rim dysplasia were measured in multiple planes.
- Growth changes were assessed using operation-to-control ratios.
Main Results:
- Generalized accelerated acetabular growth was observed in 11 of 14 hips.
- No abrupt changes in acetabular geometry were detected.
- Improved acetabular depth was noted in all hips, but 8 showed superior zonal rim dysplasia associated with smaller center-edge angles and greater deformity indices.
Conclusions:
- Shelf acetabuloplasty appears to have a favorable, growth-stimulating effect on the acetabulum.
- Preexisting zonal rim dysplasia may persist despite surgical intervention.
- CT imaging provides a more detailed assessment of acetabular morphology and growth disturbances.
