抄録
Objective: Total hip arthroplasty is a common procedure for osteoarthritis of the hip joint. However, in young patients, it is sometimes difficult to determine the correct method of surgery. We report the clinical results of Chiari pelvic osteotomy for secondary osteoarthritis due to acetabular dysplasia.
Methods: Since 2000, we have performed Chiari pelvic osteotomy for 48 hips of 45 patients (3 hips in 3 men, 42 hips in 45 women) . Of these, 34 hips in 32 patients (2 hip in 2 men, 32 hips in 30 women) could be followed. The mean age at operation was 49.2 years (range: 27 to 67 years) . Pre- and postoperative Japan Orthopaedic Association hip scores (JOA score) and roentgenographic parameters (Sharp angle, Center-edge angle, Acetabular hip index) were examined. For some patients, a questionnaire survey on activities of daily living and quality of life was performed.
Results: The mean JOA score improved from 51.1 points preoperatively to 70.5 points postoperatively. Improvement in hip pain was prominent, but not in range of motion, ability to walk and activities of daily living. JOA scores were lower in the patients with bilateral osteoarthritis, bone cysts of the femoral head, or round femoral head. The questionnaire responses suggested that coxalgia was much improved. However, half of the patients noted difficulties in some activities of daily living such as squatting down, putting on their shoes or trousers, and cutting their nails.
Conclusion: The mechanism of pain relief in Chiari pelvic osteotomy remains unclear. Further study is needed to clarify it, to improve results of treatment.
