Shelf acetabuloplasty in Perthes disease: comparison with nonoperative treatment
(2016) Current Orthopaedic Practice : a review and research journal — Vol. 27, n° 4, p. 375-381 (2016)
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- Background: The purpose of this study was to compare radiographic results between operatively and nonoperatively treated hips in patients with Perthes disease. Methods: Eighty children (88 hips) treated for Perthes disease were retrospectively reviewed with focus on the radiographic result at a mean follow-up of 6.3 yr (range 2.0 to 12.9 yr). Forty-seven hips had shelf acetabuloplasty, and 41 hips were treated nonoperatively. The radiographs were evaluated at the time of diagnosis, at 4 wk and 3 yr postoperatively (for the shelf group) and finally at latest follow-up for both groups. Results: In the nonoperatively treated group, the prognosis was initially better than in the shelf group: younger age at the time of diagnosis (4.7 vs. 6.1 yr), more Herring type A and fewer Herring type C, fewer “head at risk” signs. Stulberg’s classification at the latest follow-up showed Stulberg 1, 2 or 3 in 85% and Stulberg 4 in 15% in the nonoperative group compared with 89% and 11%, respectively, in the shelf group. Acetabular depth ratio and the migration index were better in the shelf group. Conclusions: Despite initial worse prognostic factors, final radiographic result seemed to be better in the shelf group. The shelf procedure showed radiographic improvement in the hip in Perthes disease.
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Parmentier, C., Madoki, A., Mercier, P., & Docquier, P.-L. (2016). Shelf acetabuloplasty in Perthes disease: comparison with nonoperative treatment. Current Orthopaedic Practice : a review and research journal, 27(4), 375-381. https://doi.org/10.1097/BCO.0000000000000402 (Original work published 2016)