Multivariate Analysis Of Influencing Factors Of Pemberton Acetabuloplasty For Developmental Dysplasia Of The Hip

Objective: To evaluate the relationship in Pemberton acetabuloplasty for DDH among acetabular index, femoral neck anteversion, collodiaphyseal angle and articular capsule.Methods: From 2006 to 2010, with the method of retrospective analysis ,82 children diagnosed DDH (24 hips in 18 boys and 74hips in 64 girls, age from 6~14years, average 8.5 years) was treated by Pemberton acetabuloplasty and followed up for 12 to 48 months, average 34months. Before the operations, acetabular index, femoral neck anteversion and collodiaphyseal angle are evaluated by thin slice hip joint scan and 3D reconstruction to direct the rotary osteotomy, shelf operation and contraction of articular capsule during the surgery. After the operations, acetabular index, femoral neck anteversion and collodiaphyseal angle are rechecked.Results: All the patients were followed up ranging from 12 to 48 months, average 34 months. Clinical assessment was performed according to Mckay'S classification, The results showed that excellent 76 hips (77.55%), good 16 hips (16.32%), acceptable 6 hips (6.12%),poor 0 hip (0%). Acetabular index decreased averagely 16.16°±0.73°, femoral neck anteversion decreased averagely 15.5°±1.6°and collodiaphyseal angle decreased averagely 23.3°±1.9°. Datas were analyzed by SPSS17.0 with t test, acetabular index, femoral neck anteversion and collodiaphyseal angle had significant difference with themselves before surgery(P<0.01) and had no significant difference with the normal side(P>0.05).Conclusions: Acetabular index, femoral neck anteversion, collodiaphyseal angle and articular capsule are the four most important aspects when the Developmental Dysplasia of the Hip was treated by Pemberton acetabuloplasty. The rectification of Acetabular index and femoral neck anteversion is helpful for stabilization of the hip joint. The rectification of collodiaphyseal angle is helpful to increase the coverage of acetabulum to femoral head. Shelf operation and contraction of articular capsule is necessary according to the condition of articular capsule,as it is important for capital replacement especially the prevention of redislocation of the hip. Pemberton acetabuloplasty usually involve some or all of the aspects above. Any one will effect the results of the operation.