TREATMENT OF HIP ARTHROSIS IN THE YOUNG-A DULT BY CHIARI PELVIC OSTEOTOMY - CLINICAL AND RADIOGRAPHICAL RESULTS ACCORDING TO THE INITIAL ARTHRITIS STAGE

Purpose of the study Fifty two of 53 Chiari pelvic osteotomies perform ed between 1974 and 1991 were reviewed clinically and radiographically with an average follow-up of 10,5 years. Material and methods In more than 46 per cent of cases, the osteotomy was performed on a dysplasti c painful hip with severe osteoarthritis. Major complications were rar e, The Chiari's osteotomy fixation screw was removed in 16 cases. Tech nically, the average displacement was 22 mm. A ascending osteotomy, re lated to the level of the osteotomy (p = 0,001), provided good displac ement. Results The functional results were very good or good in 65 per cent of the patients and lasted more than 10 years. Seventy five per cent of the hips were pain free. Radiographically, the center edge ang le and the femoral head covering were corrected by the procedure. Dege nerative changes of the hip joint were improved or stabilized in 63,5 per cent of the cases. Fifteen hips had undergone secondary total hip replacement, seven during the first five years and 8 after 13 years. D iscussion Factors associated with a positive outcome included: age und er 30 at the time of surgery (80 per cent of survivorship up to 15 yea rs of follow up), low stage (I or II) of osteoarthritis, and a technic ally perfect Chiari osteotomy. The outcome of initial stage III or IV initial osteoarthritis were not as long lasting. Chiari osteotomy func tional results were good for the initial 10 years, after this time the y deteriorated quickly, Conclusion Chiari pelvic osteotomy is an alter native procedure to early total hip replacement for severe painful dys plastic hips with low stage of osteoarthritis in young patients.