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Results of Tönnis-type acetabuloplasty in patients with developmental hip dysplasia
Ugur Gunel1, Bulent Daglar, Bulent A Tasbas
1Pamukkale University, Denizli, Turkey.
Insights
Tönnis acetabuloplasty effectively treats developmental dysplasia of the hip (DDH) in young children, improving hip stability and acetabular coverage with excellent clinical outcomes and no adverse growth effects.
Area of Science:
- Pediatric Orthopedics
- Hip Dysplasia Research
- Surgical Treatment Outcomes
Background:
- Developmental dysplasia of the hip (DDH) requires effective early intervention.
- Assessing surgical techniques for improving acetabular coverage is crucial.
Purpose of the Study:
- To evaluate Tönnis acetabuloplasty as a primary surgical treatment for DDH in early childhood.
- To assess the outcomes of open reduction and Tönnis acetabuloplasty in walking-age children.
Main Methods:
- Prospective study of 34 hips in 34 children (ages 12-44 months) treated with open reduction and Tönnis acetabuloplasty.
- Mean follow-up of 3.6 years, evaluating acetabular index, avascular necrosis, redislocation, and functional outcomes.
Main Results:
- 97.3% of patients achieved excellent or good clinical results.
- Acetabular angle improved significantly, from 45° preoperatively to 18° at final follow-up.
- No hip instability or need for revision surgery; two cases of type 2 avascular necrosis observed.
Conclusions:
- Tönnis acetabuloplasty enhances primary hip stability in DDH with inadequate acetabular coverage.
- The procedure demonstrates safe acetabular growth without adverse effects when performed correctly.
- Tönnis acetabuloplasty is a safe and effective standalone or combined surgical method for DDH treatment.
Aim:
The aim of this prospective study was to evaluate the outcome of open reduction and Tönnis acetabuloplasty as the first method of treating developmental dysplasia of the hip (DDH) in children in early childhood at walking age.
Materials And Methods:
Between 2005 and 2009, 34 hips of 34 children were operated on with the aforementioned method. Mean age was 25.6 (range 12-44) months, and mean follow-up was 3.6 years. During the follow-up period ,the hips were evaluated using the acetabular index and for development of avascular necrosis and redislocation. Functional evaluation was also conducted.
Results:
Clinically, 97.3 % of patients had excellent and good results. The acetabular angle decreased from 45° preoperatively to 21° early postoperatively and at the last follow-up had improved to 18°. In two hips, type 2 avascular necrosis developed. Hip instability was not observed, and no additional surgery was performed.
Conclusion:
Tönnis acetabuloplasty is a powerful tool to increase primary stability of the hip when acetabular coverage is inadequate in DDH. Besides its acute correction ability, when performed properly, it has no unwanted effects on acetabular growth. As an isolated procedure or as a part of combined open reduction and/or femoral osteotomy, Tönnis type acetabuloplasty is a safe and effective method.
