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Chiari pelvic osteotomy does affect hip survival: a long-term follow-up study
Josko Jelicic1, Antea Buterin1, Goran Vrgoc2
1Special Hospital for Orthopaedics Biograd Na Moru, Biograd Na Moru, Croatia.
Insights
Chiari pelvic osteotomy (CPO) can yield satisfactory results in selected younger patients with hip osteoarthritis, even with advanced disease. This joint-conserving procedure may delay the need for total hip arthroplasty (THA).
Area of Science:
- Orthopedic surgery
- Hip joint preservation
- Osteoarthritis treatment
Background:
- Chiari pelvic osteotomy (CPO) indications have narrowed, with decreased surgical frequency.
- Published long-term data suggest CPO can achieve satisfactory functional outcomes in select patients.
- Investigating factors influencing CPO survival and conversion to total hip arthroplasty (THA) is crucial.
Purpose of the Study:
- To identify parameters affecting the long-term survival of Chiari pelvic osteotomy (CPO).
- To analyze factors influencing the conversion rate of CPO to total hip arthroplasty (THA).
Main Methods:
- Single-center retrospective case-series study.
- Included 172 CPO procedures in 158 patients (1976-2012).
- Final analysis included 115 patients (124 CPO) with a median follow-up of 19 years.
Main Results:
- 51 total hip arthroplasties (THA) were performed in 49 patients out of 124 CPO procedures.
- The median time from CPO to THA was 14 years.
Conclusions:
- CPO remains a viable joint-preserving option for younger patients with advanced hip osteoarthritis.
- Patients should be selected carefully, understanding the potential for a less optimal outcome compared to primary THA.
- CPO may serve as a valuable procedure to delay THA in appropriate candidates.
Background:
The modern indications for Chiari pelvic osteotomy (CPO) have narrowed and the number of such operations performed has diminished markedly. So far published long-term experience with CPO indicate the fact that in selected patients satisfactory functional results can be achieved. The aim of this study was to investigate the parameters which influence CPO survival and its conversion into total hip arthroplasty (THA).
Methods:
This is a single-centre retrospective case-series study. In the period from 1976 to 2012, it included 172 CPO in 158 patients. Of those, in 43 patients (48 hips) the follow-up was discontinued, leaving 115 patients (124 hips) for final analyses. The median age at the time of the surgery was 34 years, and the mean duration of the follow-up was 19 years.
Results:
In 115 patients (124 CPO) included in the study, a total of 51 THA was performed in 49 patients. The median period between CPO and THA was 14 years.
Conclusion:
Supporting our results, we suggest that CPO should still be indicated in a selected group of younger patients even with advanced stage of hip osteoarthritis who prefer a joint-conserving procedure and consent to a predicted less optimal outcome.
