DYNAMICS OF HIP-JOINT REMODELING AFTER CHIARI OSTEOTOMY - 10 PATIENTSWITH NEUROMUSCULAR DISEASE FOLLOWED FOR 8 YEARS

We analyzed the development of 10 hips in 10 consecutive patients with neuromuscular disease (9 with spasticity, 1 with Charcot-Marie-Tooth disease) who had undergone Chiari osteotomy for painful hip subluxatio n or dislocation. The patients were 11 (5-19) years old at surgery and follow-up time was 8 (6-11) years. The Chiari osteotomy particularly improved and maintained femoral head coverage. These parameters did no t show the postoperative deterioration noted in some other studies. Th e osteotomy did not improve femoral bead lateral displacement. Through out the postoperative period, the configuration of the proximal femur and the height of the joint cartilage were unchanged and undisturbed, indicating that osteotomy did not place excessive or uneven pressure o n the femoral head. The ambulatory status of the patients was dependen t on the severity of the underlying disease, and was not improved by o steotomy. However, pain associated with subluxation or dislocation was reduced in 9 of the patients.