Background: Controversy exists whether previous pelvic osteotomies have negative effects on total hip arthroplasty (THA). This study evaluates the implant survival and patient-reported outcomes of THA after previous Chiari pelvic osteotomy (CPO).
Methods: Data on 301 THAs after CPO were collected through clinical and radiological follow-up examinations and telephone interviews. The Kaplan-Meier survivorship analysis depicts implant survival.
Results: Of this consecutive series of 1536 CPOs, follow-up was completed in 405 patients with 504 CPOs after a mean time of 36 years (±8; range, 22-54 years). At follow-up, 301 hips (60%) had already undergone THA. The overall survival of THA with revision as an end point after 10, 20, and 25 years was 93%, 76%, and 68%, respectively. The revision rate was 12%. The average period between THA and revision surgery was 9.6 years (±6.1; 4 months-25.4 years). The patient's age at revision was 57.9 years (±10; 33.2-78.5 years). Aseptic loosening was the most common of the known reasons for revision surgery.
Conclusion: This retrospective study supports the hypothesis that prior CPO does not compromise the prerequisites for successful THA at a later stage. Survival rates of the implanted prosthesis are comparable to primary implanted hips, as overall survival was 93% after 10 years.
Keywords: Chiari pelvic osteotomy; developmental dysplasia of the hip; long-term survival; revision; total hip arthroplasty.
Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.