Lateral shelf acetabuloplasty: Surgical outcomes in patients with residual hip dysplasia

Abstract

In treating developmental dysplasia of the hip (DDH), the goal is to realign the femoral head with its native acetabulum, which can occur at any age. In older children, concentric reduction is challenging especially with flattened femoral head or dysplastic acetabulum that make open reduction and some acetabuloplasty procedures difficult to be applied due to the risk of incongruence, arthritis beside vascular serious complications,. Another barrier that hinders anatomic reduction is soft tissue contracture which, may increase the incidence of some complications, such as the femoral head avascular necrosis. Shelf acetabuloplasty can be a good option for those cases avoiding vascular risks of other reorientation osteotomies, In order to prevent or postpone the development of arthritis, it is necessary to distribute stress evenly over the acetabular cartilage and provide adequate coverage of the femoral head. Objective: To assess both the functional outcomes and radiological impacts of the shelf acetabuloplasty procedure in patients who have residual hip dysplasia. Patients and Methods: 30 hips with residual hip dysplasia were treated by lateral shelf acetabuloplasty. The mean age was 10.5 years (range: 8-15 years). Results: 18 patients (60%) had a poor score according to modified Sundt criteria while 12 patients (40%) had a fair score preoperatively. At the one-year follow-up, 20 patients (66.7%) had a good score, 8 patients (26.7%) had a fair score, and 2 patients (6.6%) had a poor score. Conclusion: Lateral shelf acetabuloplasty can be a good option for children with residual hip dysplasia and have a favorable short term outcome at 1 year follow up.