Chiari's Pelvic Osteotomy in the Adult. A Long Term Clinical, Radiological and Statistical Evaluation

Abstract

Chiari's pelvic osteotomy, conceived for the surgical correction of congenital dysplasia of the hip, is indicated by some authors for juvenile patients (16 years of age: Graham et al (7); 18 years of age: Hogh and Macnicol (9); 19.8 years of age: Calvert et al (1), while others do not identify any age limit (2, 11). Retrospectively reviewing a series of adult patients, we tried to determine the optimum age range of Chiari's osteotomy, and to evaluate the relative importance of surgical and radiological parameters of the results.We reviewed 74 patients, mean age 38.5 years, for a total number of 80 operations; 72.6% were aged between 31 and 60 years. The follow-up interval ranged from 1.8 to 15 years - mean 6.6, 180 months -. The results, based on a mathematical evaluation of pain, walking, joint mobility, limping and Trendelenburg's sign, were: 31 excellent (38.8%), 25 good (31.3%), 18 fair (22.5%), and 6 poor (7.5%). The best results were numerically concentrated in the 41-50 age group, in terms of percentages, we found a constant decrease of the good results in the different decades. Pain was absent in 61 of 80 cases.Clinical and radiological data, plus the statistical correlation of the different data (17 parameters), showed that Chiari's osteotomy is valid for the treatment of CDH even in older patients, although the best results are obtained in the 21-50 age group.