The results of Pemberton's pericapsular osteotomy in patients with developmental hip dysplasia

Abstract

Objective: The aim of this study was to investigate the radiological and clinical outcomes of Pemberton s pericapsular osteotomy in toddlers and preschool children with developmental hip dysplasia. Methods: Ninety-one hips of 86 patients (81 girls, 5 boys) with developmental hip dysplasia who underwent Pemberton s pericapsular osteotomy were included in this study. The mean age of the patients was 34 (range: 18 to 96) months. The mean duration of follow-up was 60 (range: 24 to 158) months. All patients underwent open reduction and Pemberton s pericapsular osteotomy, including 12 hips in which proximal femur osteotomy had been performed earlier. Clinical results were evaluated according to McKay s clinical evaluation criteria, radiological results according to Sever s radiological evaluation criteria, and the presence of avascular necrosis according to Kalamchi-MacEwen s classification criteria. Results: At the final examinations the mean acetabular index was 12.04° (range: 5° to 24°) and the mean Wiberg s center-edge angle was 35.5° (range: 20° to 52°). Clinically, excellent results were obtained in 81 (89.0%) hips, good results were obtained in 2 (2.2%) hips, and fair results in 8 (8.8%) hips. Radiologically, excellent results were obtained in 79 (86.8%) hips, good results in 7 (7.7%) and fair results in 5 (5.5%) hips. Clinically and radiologically no poor results were noted. Type 1 avascular necrosis was detected in 9 (9.9%) hips, Type 2 in 7 (7.7%) hips, and Type 3 in one (1.1%) hip. There were no cases with Type 4 avascular necrosis. Conclusion: Pemberton s pericapsular osteotomy is a safe and effective procedure for the surgical treatment of developmental hip dysplasia in toddlers and preschool children.