Short-term results of Pemberton pericapsular osteotomy for the treatment of developmental dysplasia of the hip

Abstract

Objectives: We evaluated the short-term results of Pemberton pericapsular osteotomy for the treatment of developmental dysplasia of the hip (DDH).
Patients and methods: Fifteen patients (14 girls, 1 boy; mean age 2.5 years; range 1.5 to 3 years) with DDH underwent Pemberton pericapsular osteotomy in 20 hips. Five patients had bilateral involvement. According to the Tönnis classification, 16 hips (80%) were rated as grade IV, and four hips (20%) were rated as grade III. None of the patients underwent skeletal or skin traction preoperatively. A tricortical trapezoidal iliac graft was placed in the osteotomy space and was fixed with a K-wire. Shortening and derotation were performed in seven of the high-riding hips. The acetabular index was measured on pre- and postoperative pelvic radiographs. Clinical evaluations were made according to the McKay criteria, and avascular necrosis of the femur head was assessed using the Kalamchi-MacEwen criteria. The mean follow-up period was 3.6 years (range 1 to 6 years).
Results: Clinical results were excellent in 10 hips (50%), good in eight hips (40%), and moderate in two hips (10%). The mean acetabular index decreased from 40° to 18° postoperatively. According to the Kalamchi-MacEwen criteria, six hips (30%) developed type I, three hips (15%) developed type II avascular necrosis. Postoperative dislocation, subluxation, or dysplasia were not detected in any of the patients.
Conclusion: Pemberton pericapsular osteotomy was found to be safe and successful in the short-term follow-up of patients with DDH.