H Migaud1, S Putman2, C Berton3, C Lefèvre4, D Huten5, J-N Argenson6, F Gaucher7. 1. Service d'orthopédie C, département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille, France; Faculté de médecine, université Lille-Nord-de-France, place de Verdun, 589045 Lille, France. Electronic address: hemigaud@nordnet.fr. 2. Service d'orthopédie C, département universitaire de chirurgie orthopédique et de traumatologie, hôpital Salengro, CHRU de Lille, place de Verdun, 59037 Lille, France; Faculté de médecine, université Lille-Nord-de-France, place de Verdun, 589045 Lille, France. 3. Faculté de médecine, université Lille-Nord-de-France, place de Verdun, 589045 Lille, France; Service d'orthopédie-traumatologie, centre hospitalier de Valenciennes, avenue Désandrouin, 59322 Valenciennes cedex, France. 4. Service de chirurgie orthopédique et de traumatologie, hôpital Cavale-Blanche, CHRU de Brest, boulevard Tanguy-Prigent, 29609 Brest cedex, France. 5. Service de chirurgie orthopédique et de traumatologie, CHU de Rennes, 16, boulevard de Bulgarie, BP 90347, 35000 Rennes, France. 6. Institut du mouvement et de l'appareil locomoteur, service de chirurgie orthopédique, hôpital Sainte-Marguerite, université Aix-Marseille, CHU de Marseille, AP-HM, 270, boulevard de Sainte-Marguerite, 13009 Marseille, France. 7. Service de chirurgie orthopédique et de traumatologie, Hôtel-Dieu, rue Roger-Signor, 29120 Pont l'Abbé, France.
Abstract
INTRODUCTION: The results of total hip arthroplasty (THA) in congenital dislocation of the hip (CDH) are well known, but such is not the case for the impact of prior conservative surgery on THA function and survivorship. The present study compared THA in CDH with prior conservative bone surgery (BS group) versus no prior bone surgery (NBS group), to (1) assess the impact of prior conservative surgery on function and survivorship after THA, and (2) determine whether a particular type of conservative surgery affected function or survivorship. HYPOTHESIS: Prior conservative surgery for CDH does not affect function or survivorship of subsequent THA. PATIENTS AND METHODS: A multicenter retrospective case-control study analyzed 430 THAs in CDH patients (332 patients: 269 female, 63 male; mean age, 56 years [range, 17-80 years]) at a mean 13.2±5.4 years' follow-up (range, 1-29 years). The BS group included 159 hips (37%) (64 pelvic, 81 femoral and 14 combined pelvic and femoral osteotomies), and the NBS group 271 (63%). Groups were comparable for gender, age at surgery, Devane activity score, preoperative Postel Merle d'Aubigné (PMA) functional score and CDH radiographic type following Crowe. RESULTS: At follow-up, PMA scores were comparable: BS, 16.8±1.4 (11-18); NBS, 16.9±1.5 (7-18). Fifteen-year survivorship censored for implant revision for whatever reason did not significantly differ: BS, 87% (95% CI: 83-91%); NBS, 89% (95% CI: 86-92%). Ten-year survivorship on the same criterion did not significantly differ according to type of prior surgery: hip shelf arthroplasty, 97% (95% CI: 95-99%); Chiari osteotomy, 100%; femoral osteotomy, 95% (95% CI: 92-98%); and Milch osteotomy 96% (95% CI: 93-99%). DISCUSSION/ CONCLUSION: Conservative surgery for CDH does not impair the functional results or survivorship of subsequent THA. LEVEL OF EVIDENCE: III, case-control study.
INTRODUCTION: The results of total hip arthroplasty (THA) in congenital dislocation of the hip (CDH) are well known, but such is not the case for the impact of prior conservative surgery on THA function and survivorship. The present study compared THA in CDH with prior conservative bone surgery (BS group) versus no prior bone surgery (NBS group), to (1) assess the impact of prior conservative surgery on function and survivorship after THA, and (2) determine whether a particular type of conservative surgery affected function or survivorship. HYPOTHESIS: Prior conservative surgery for CDH does not affect function or survivorship of subsequent THA. PATIENTS AND METHODS: A multicenter retrospective case-control study analyzed 430 THAs in CDHpatients (332 patients: 269 female, 63 male; mean age, 56 years [range, 17-80 years]) at a mean 13.2±5.4 years' follow-up (range, 1-29 years). The BS group included 159 hips (37%) (64 pelvic, 81 femoral and 14 combined pelvic and femoral osteotomies), and the NBS group 271 (63%). Groups were comparable for gender, age at surgery, Devane activity score, preoperative Postel Merle d'Aubigné (PMA) functional score and CDH radiographic type following Crowe. RESULTS: At follow-up, PMA scores were comparable: BS, 16.8±1.4 (11-18); NBS, 16.9±1.5 (7-18). Fifteen-year survivorship censored for implant revision for whatever reason did not significantly differ: BS, 87% (95% CI: 83-91%); NBS, 89% (95% CI: 86-92%). Ten-year survivorship on the same criterion did not significantly differ according to type of prior surgery: hip shelf arthroplasty, 97% (95% CI: 95-99%); Chiari osteotomy, 100%; femoral osteotomy, 95% (95% CI: 92-98%); and Milch osteotomy 96% (95% CI: 93-99%). DISCUSSION/ CONCLUSION: Conservative surgery for CDH does not impair the functional results or survivorship of subsequent THA. LEVEL OF EVIDENCE: III, case-control study.
Authors: Kevin Benad; Pierre Martinot; Julien Dartus; Julien Girard; Sophie Putman; Henri Migaud Journal: Int Orthop Date: 2022-02-03 Impact factor: 3.075