CLINICAL RESULTS OF TRIPLE PELVIC OSTEOTOMY FOR DYSPLASTIC COXARTROSIS IN ADULTS

Abstract

The article presents a comparison analysis of clinical results of treatment of 67 patients who underwent triple pelvic osteotomy (81 cases) by A. M. Sokolovsky in the two groups. The control group consisted of 33 patients (40 operational interventions), who were operated according to the original technique of the author. The main group consisted of 34 patients who underwent 41 triple osteotomy of the pelvis using the modifications we proposed. Clinical assessment of the condition of the affected joints was performed according to the system proposed by Tschauner. When assessing the long-term results with a median follow-up of 107.5 (40–171) months in the control group, we obtained excellent and good results in 47.5 % of the cases. In the main groupwith a median follow-up of 107 (42–168) months excellent and good results were 70.8 % of the cases. When performing the operation with the modified technology, we obtained a significantly reduced number of complications in the form of nonunion of the pelvic bones from 35.0 to 14.6 %. Triple pelvic osteotomy according to A. M. Sokolovsky is a highly effective intervention capable of restoring normal or close to normal biomechanical conditions of dysplastic hip joint functioning in adults and should be considered as a surgery of choice. Use of the proposed variants of the osteotomy of the ischial bone and more rigid fixation of an acetabular fragment, replacement of defects in the sites of osteotomy after the reorientation of the acetabulum with bone grafts reduces the number of complications and improves the treatment results.