Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study
The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included deter...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/12/5/1837 |
| _version_ | 1797615027775078400 |
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| author | Kamil Kołodziejczyk Adam Czwojdziński Maria Czubak-Wrzosek Jarosław Czubak |
| author_facet | Kamil Kołodziejczyk Adam Czwojdziński Maria Czubak-Wrzosek Jarosław Czubak |
| author_sort | Kamil Kołodziejczyk |
| collection | DOAJ |
| description | The aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included determining the center-edge angle (CEA), medialization, distalization, femoral head coverage (FHC), and ilioischial angle as measured on a standardized AP radiograph of the hip joints. Clinical evaluation was based on the HHS, WOMAC, Merle d’Aubigne–Postel scales and Hip Lag Sign. The results of PAO presented decreased medialization (mean 3.4 mm), distalization (mean 3.5 mm), and ilioischial angle (mean 2.7°); improvement in femoral head bone cover; an increased CEA (mean 16.3°) and FHC (mean 15.2%); clinically increased HHS (mean 22 points) and M. Postel–d’Aubigne (mean 3.5 points) scores; and a decrease in WOMAC (mean 24%). HLS improved in 67% of patients after surgery. Qualification of patients with DDH for PAO should be based on the following values of three parameters: CEA < 26°, FHC < 75%, and ilioischial angle >85.9°. To achieve better clinical results, it is necessary to increase the average CEA value by 11° and the average FHC by 11% and reduce the average ilioischial angle by 3°. |
| first_indexed | 2024-03-11T07:20:39Z |
| format | Article |
| id | doaj.art-7d3613c80a1d4988a4c6a8a24ca10635 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-11T07:20:39Z |
| publishDate | 2023-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-7d3613c80a1d4988a4c6a8a24ca106352023-11-17T07:59:01ZengMDPI AGJournal of Clinical Medicine2077-03832023-02-01125183710.3390/jcm12051837Radiologic Predictors for Clinical Improvement in PAO—A Perspective StudyKamil Kołodziejczyk0Adam Czwojdziński1Maria Czubak-Wrzosek2Jarosław Czubak3Department of Orthopaedics, Children’s Orthopaedics and Traumatology, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, PolandDepartment of Orthopaedics, Children’s Orthopaedics and Traumatology, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, PolandDepartment of Spine Disorders and Orthopedics, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, PolandDepartment of Orthopaedics, Children’s Orthopaedics and Traumatology, Centre of Postgraduate Medical Education, Professor A. Gruca Teaching Hospital, Konarskiego 13, 05-400 Otwock, PolandThe aim of this study was to evaluate the results of surgical treatment of developmental dysplasia of the hip (DDH) with periacetabular osteotomy (PAO) and determine the values of radiological parameters that would allow us to obtain an optimal clinical result. Radiological evaluation included determining the center-edge angle (CEA), medialization, distalization, femoral head coverage (FHC), and ilioischial angle as measured on a standardized AP radiograph of the hip joints. Clinical evaluation was based on the HHS, WOMAC, Merle d’Aubigne–Postel scales and Hip Lag Sign. The results of PAO presented decreased medialization (mean 3.4 mm), distalization (mean 3.5 mm), and ilioischial angle (mean 2.7°); improvement in femoral head bone cover; an increased CEA (mean 16.3°) and FHC (mean 15.2%); clinically increased HHS (mean 22 points) and M. Postel–d’Aubigne (mean 3.5 points) scores; and a decrease in WOMAC (mean 24%). HLS improved in 67% of patients after surgery. Qualification of patients with DDH for PAO should be based on the following values of three parameters: CEA < 26°, FHC < 75%, and ilioischial angle >85.9°. To achieve better clinical results, it is necessary to increase the average CEA value by 11° and the average FHC by 11% and reduce the average ilioischial angle by 3°.https://www.mdpi.com/2077-0383/12/5/1837hip dysplasiaPAODDHilioischial anglehip joint preservation |
| spellingShingle | Kamil Kołodziejczyk Adam Czwojdziński Maria Czubak-Wrzosek Jarosław Czubak Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study Journal of Clinical Medicine hip dysplasia PAO DDH ilioischial angle hip joint preservation |
| title | Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study |
| title_full | Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study |
| title_fullStr | Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study |
| title_full_unstemmed | Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study |
| title_short | Radiologic Predictors for Clinical Improvement in PAO—A Perspective Study |
| title_sort | radiologic predictors for clinical improvement in pao a perspective study |
| topic | hip dysplasia PAO DDH ilioischial angle hip joint preservation |
| url | https://www.mdpi.com/2077-0383/12/5/1837 |
| work_keys_str_mv | AT kamilkołodziejczyk radiologicpredictorsforclinicalimprovementinpaoaperspectivestudy AT adamczwojdzinski radiologicpredictorsforclinicalimprovementinpaoaperspectivestudy AT mariaczubakwrzosek radiologicpredictorsforclinicalimprovementinpaoaperspectivestudy AT jarosławczubak radiologicpredictorsforclinicalimprovementinpaoaperspectivestudy |