Comparison of Iliac and Femoral Autograft Practices in Pemberton Pelvic Osteotomy
OrthoEvidence Journal (OE Journal) - ACE Report
OE Journal. 2021;9(4):13 J Pediatr Orthop. 2021 Jan;41(1):46-50.What this means for my practice?
The results of this randomized controlled study suggest that in patients with developmental hip dysplasia who are treated with Pemberton pelvic osteotomy, a femoral graft compared to using an iliac graft may help improve blood loss and loss of graft height up to 3 months post-treatment. However, the time to graft union may be statistically significantly shorter when using the iliac graft vs femoral graft after a pelvic osteotomy. The results of this study were limited by the lack of blinding of outcome assessors. Moreover, the sample size was small with 50 patients; thus, future larger randomized controlled trials are needed.
Zusammenfassung der Studie
Fifty patients (60 hips) aged >18 months to 6 years old with developmental dysplasia of the hip (DDH) scheduled for an open reduction, Pemberton pelvic osteotomy (PPO), and femoral shortening osteotomy were randomized to receive either iliac autograft (n=30 hips) or femoral autograft (n=30 hips) after PPO. Outcomes of interest included the following: acetabular index angle (AIA), time of surgery, mean blood loss, mean time to graft union, mean graft height and width, mean loss of graft height and width, and the incidence of complications (i.e. loss of graft position, graft resorption). AIA was evaluated at 1-day, 45-days, and 1-year post-surgery, whilst mean graft height, was assessed at 45-days and 1-year post-surgery. All other outcomes, excluding mean loss of graft height which was evaluated at 90-days follow-up, were measured peri-operatively. Results of this study demonstrated that the mean AIA, mean surgical time, and incidence of adverse events were not statistically significantly different between the two graft groups (p>0.05 for all). Furthermore, mean peri-operative graft width, mean graft height, mean loss of graft height, and mean blood loss were all statistically significantly in favour of the femoral autograft group (p<0.001 for all). Yet, mean time to graft union was statistically significantly in favour of the iliac autograft group (p=0.0001). Two patients experienced loss of graft position, and 1 patient experienced graft resorption. No cases of superficial/deep infections, neurovascular injury, or nonunion at the osteotomy line were observed in either group.
Vollständigen ACE-Bericht freischalten
Sie haben Zugang zu 4 weiteren KOSTENLOSEN Artikeln in diesem Monat.
Klicken Sie unten, um diese ACE Reports freizuschalten und anzusehen
Jetzt freischalten
Kritische Beurteilungen der neuesten, hochwirksamen randomisierten kontrollierten Studien und systematischen Übersichten in der Orthopädie
Zugang zu OrthoEvidence-Podcast-Inhalten, einschließlich Kooperationen mit dem Journal of Bone and Joint Surgery, Interviews mit international anerkannten Chirurgen und Diskussionsrunden zu orthopädischen Neuigkeiten und Themen
Abonnement von The Pulse, einem zweimal wöchentlich erscheinenden evidenzbasierten Newsletter, der Ihnen helfen soll, bessere klinische Entscheidungen zu treffen
Exklusiver Zugang zu Originalartikeln, einschließlich eigener systematischer Übersichten, sowie zu Artikeln über Methoden der Gesundheitsforschung und aktuelle orthopädische Themen
Oder upgraden Sie noch heute und erhalten Sie Zugang zu allen OrthoEvidence-Inhalten für nur $1,99 pro Woche.
Sie haben bereits ein Konto? Einloggen
Gehören Sie zu einem unserer Partnerverbände?
Klicken Sie hier, um im Rahmen Ihrer Verbandsmitgliedschaft kostenlosen Zugang zu erhalten!