[Results between 5 and 10 years of Chiari pelvic osteotomy in advanced hip arthrosis]

Thirty-two evolved coxarthritis in adults were operated on by Chiari pelvic osteotomy. Seventeen osteotomies were only pelvic. They concerned fourteen dysplastic hips and three primary coxarthritis. In ten cases, an additional intertrochanteric osteotomy of valgisation was performed in the same procedure. The intertrochanteric valgisation aimed to put in load bearing the medial part of a flattened head (nine out ten cases) and the Chiari to stabilize the hip. At last in five cases the Chiari can be considered as a salvage procedure aiming to delay a degradation of a previous intertrochanteric osteotomy. After a mean of follow-up of 6.4 years (from five to ten years), the results were good: twenty five hips has no clinical degradation. Among them twenty two has excellent to good result, according to the Merle d'Aubigné scale. Twenty four out those twenty five hips showed either widening of the joint space or no modification and twenty showed better congruity. In case of subluxated hip with flattened head, intertrochanteric valgisation osteotomy combined to the Chiari in the same procedure seemed to improve the quality of the results. That explains, perhaps, the lack of correlation found between the stage of arthritis and the results. Complications were very few (one transitory paresia of the peroneal nerve). All osteotomies healed, with a simple lying in bed of forty five days without fixation of the shaft nor plaster. Out of fast hip destructions, no formal contraindication could be found. But indications must be prudent over fifty years, in cases of necrosis and in cases of total joint space narrowing.