Abstract
This study involved patients who received valgus osteotomy plus Chiari osteotomy. They were divided into two groups. Group A, whose acetabular coverage was still insufficient, nine patients and ten hips, average age forty at the time of operation, received a shelf operation in addition to the valgus and Chiari osteotomies, and were followed up for an average of eight years and four months. Group B, fifteen patients and fifteen hips, average age forty-one at the time of operation, received only the valgus and Chiari osteotomies (no shelf operation), and were followed up for an average of five years. In group A, the acetabular head index (Au) was 50.0% before operation, 72.8% after the Chiari osteotomy, and finally 107.6% after the shelf operation. In group B, AHI was 51.4% before operation, and 83.9% after the Chiari osteotomy. The clinical score of the Japanese Orthopedic association at the time of follow-up were 93.3 points for group A, and 90.1 points for group B, representing no significant difference between the groups. Moreover, according to radiological assessment, 80.0% of group A, and 73.3% of group B, were excellent. The long-term results of this additional shelf procedure are yet unknown, but the patients are doing well so far, with no complications. Our former investigation for more than ten years follow-up shows that the excellent cases had AHI of more than 80%. It seems that sufficient acetabular coverage should be obtained in order to maintain good condition for as long as possible after recovery from osteoarthritis with valgus osteotomy.
