Hip arthrotomy after a periacetabular osteotomy for the management of hip dysplasia intra-articular joint injuries in adolescents and young adults

Authors

  • Luis Fernando Useche Hospital Universitario La Samaritana. Bogotá, Colombia
  • Catherine Novoa Rámirez Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia
  • Jorge Eduardo Portela García Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia
  • Karen Juliethd Moreno M. Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

DOI:

https://doi.org/10.1016/S0120-8845(13)70012-9

Keywords:

hip dislocation, congenital, osteotomy/methods, hip joint/abnormalities, diagnosis, physical examination, predictive value of tests, adolescent, young adult, evidence level: IV

Abstract

Introduction: Main 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 methods: We 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.
Results: A 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.
Discussion: The 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.

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Author Biographies

Luis Fernando Useche, Hospital Universitario La Samaritana. Bogotá, Colombia

Ortopedista, cirujano de cadera, candidato a magíster en Epidemiología. Coordinador de la clínica de Cadera del Adolescente, Instituto de Ortopedia Infantil Roosevelt. Coordinador de Cirugía Reconstructiva de Cadera, Hospital Universitario La Samaritana, Bogotá, Colombia.

Catherine Novoa Rámirez, Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Médico, residente de 2.° año de Ortopedia, Universidad del Rosario. Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

Jorge Eduardo Portela García, Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Médico, residente de 4.° año de Ortopedia, Universidad del Bosque. Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

Karen Juliethd Moreno M., Instituto de Ortopedia Infantil Roosevelt. Bogotá, Colombia

Fisioterapeuta, epidemióloga. Instituto de Ortopedia Infantil Roosevelt, Bogotá, Colombia.

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Published

2013-09-25

How to Cite

1.
Useche LF, Novoa Rámirez C, Portela García JE, Moreno M. KJ. Hip arthrotomy after a periacetabular osteotomy for the management of hip dysplasia intra-articular joint injuries in adolescents and young adults. Rev. colomb. ortop traumatol. [Internet]. 2013 Sep. 25 [cited 2024 May 19];27(3):155-9. Available from: https://revistasccot.org/index.php/rccot/article/view/480

Issue

Vol. 27 No. 3 (2013)

Section

Original research

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