Artrotomía de cadera después de una osteotomía periacetabular para el manejo de lesiones intraarticulares de la cadera displásica en adolescentes y adultos jóvenes

Abstract

IntroductionMain objective of the study is to determine the prevalence of joint injuries in patients with symptomatic hip dysplasia requiring re-orienting periacetabular osteotomy and to establish, according to this finding, the requirement of an arthrotomy after performing the osteotomy to correct those injuries. Materials and methodsWe designed a cross-sectional study. A systematic record was made of the clinical symptoms and signs associated with lesions in the hip: pain, lameness, impingement test, and length discrepancy. A diagnostic test accuracy analysis was performed for these signs and symptoms (sensitivity, specificity, positive predictive value and negative predictive value), and the results were analyzed according to age and history of previous surgery. Finally, a Fisher exact test was performed to determine if there was a statistically significant relationship between the presence of joint injury, previous surgery and age group. ResultsA total of 34 patients aged between 10 and 46 years were evaluated. Of these, 85% of patients had pain, 29% an impingement test, and 50% lameness. Almost two-thirds (62%) of the patients required surgical correction of joint injuries. In the analysis of diagnostic test, it showed that the presence of the three signs has a sensitivity of 96% and a specificity of 17% for the diagnosis of joint injuries. Finally, a significant association (P<.05) was found between the presence of joint injuries and being older than 15 years. DiscussionThe presence of pain during physical examination (impingement test), being more than 15 years, and previous hip surgery for hip dysplasia treatment, are key factors that should enable the surgeon to explore the hip joint by an arthrotomy after having performed a periacetabular osteotomy.