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Total Hip Arthroplasty after Previous Chiari Pelvic Osteotomy-A Retrospective Study of 301 Dysplastic Hips
Eleonora Schneider1, Tanja Stamm2, Martina Schinhan1
1Department of Orthopaedics and Trauma Surgery, Medical University of Vienna, Vienna, Austria.
Insights
Total hip arthroplasty (THA) after Chiari pelvic osteotomy (CPO) demonstrates favorable implant survival. Prior CPO does not negatively impact THA success, with 10-year survival rates comparable to primary hip replacements.
Area of Science:
- Orthopedic surgery
- Arthroplasty
- Pelvic osteotomy
Background:
- Debate exists regarding the impact of prior pelvic osteotomies on subsequent total hip arthroplasty (THA) outcomes.
- Chiari pelvic osteotomy (CPO) is a surgical procedure to treat hip dysplasia.
Purpose of the Study:
- To evaluate the implant survival and patient-reported outcomes of THA following a previous CPO.
- To determine if CPO negatively affects the success of later THA.
Main Methods:
- Retrospective analysis of 301 THAs performed after CPO.
- Kaplan-Meier survivorship analysis for implant survival.
- Clinical and radiological follow-up, including telephone interviews.
Main Results:
- Overall THA survival at 10, 20, and 25 years was 93%, 76%, and 68%, respectively.
- The revision rate for THA after CPO was 12%, with aseptic loosening being the most common reason.
- Mean follow-up was 36 years after CPO, with THA performed at a mean of 36 years post-CPO.
Conclusions:
- Prior CPO does not compromise the success of subsequent THA.
- THA survival rates after CPO are comparable to those of primary THA.
- The findings support performing THA after CPO when indicated.
Background:
Controversy exists whether previous pelvic osteotomies have negative effects on total hip arthroplasty (THA). This study evaluates the implant survival and patient-reported outcomes of THA after previous Chiari pelvic osteotomy (CPO).
Methods:
Data on 301 THAs after CPO were collected through clinical and radiological follow-up examinations and telephone interviews. The Kaplan-Meier survivorship analysis depicts implant survival.
Results:
Of this consecutive series of 1536 CPOs, follow-up was completed in 405 patients with 504 CPOs after a mean time of 36 years (±8; range, 22-54 years). At follow-up, 301 hips (60%) had already undergone THA. The overall survival of THA with revision as an end point after 10, 20, and 25 years was 93%, 76%, and 68%, respectively. The revision rate was 12%. The average period between THA and revision surgery was 9.6 years (±6.1; 4 months-25.4 years). The patient's age at revision was 57.9 years (±10; 33.2-78.5 years). Aseptic loosening was the most common of the known reasons for revision surgery.
Conclusion:
This retrospective study supports the hypothesis that prior CPO does not compromise the prerequisites for successful THA at a later stage. Survival rates of the implanted prosthesis are comparable to primary implanted hips, as overall survival was 93% after 10 years.
