San Diego pelvic osteotomy in patients with closed triradiate cartilage

J. Murar*, L. S. Dias, Vineeta T Swaroop

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Purpose A San Diego pelvic osteotomy is frequently used as part of the surgical treatment of neuromuscular patients with hip displacement. This short-term follow-up study assesses the effectiveness of this osteotomy in patients with closed tri-radiate cartilage compared with open triradiates. Methods Retrospective review of 43 patients (44 hips) with neuromuscular hip disease who underwent a San Diego pelvic osteotomy to correct hip displacement. In all 24 hips had open triradiate cartilage at the time of surgery and 20 hips were closed. Centre edge angle (CEA), acetabular angle (AA) and Reimer’s index (RI) were recorded from preoperative, postoperative and the latest follow-up radiographs and statistical analysis was performed. Results CEA improved by 39° (7° to 69°) in the open group and 30° (9° to 80°) in the closed group from preoperative radiographs to postoperative, with no significant difference in improvement between groups (p = 0.084). There was no significant difference in AA between the open (improved by 11° (3° to 23°)) and closed (improved by 10° (4° to 21°)) groups (p = 0.65). RI improved from 61% to 11% in the open group and 51% to 12% in the closed group. There was no statistically significant difference between groups in RI at preoperative, immediate postoperative and final follow-up radiographs. At latest follow-up, CEA, AA and RI all remained relatively stable in both groups. Conclusions San Diego pelvic osteotomy is equally effective in improving radiographic parameters in neuromuscular patients with both open and closed triradiate cartilage. This study challenges the notion that closed triradiate cartilage is a contraindication to a San Diego pelvic osteotomy.

Original languageEnglish (US)
Pages (from-to)461-471
Number of pages11
JournalJournal of Children's Orthopaedics
Volume12
Issue number5
DOIs
StatePublished - Oct 2018

Keywords

  • Closed triradiate cartilage
  • Hip displacement
  • Neuromuscular hip disease
  • Pelvic osteotomy
  • San Diego osteotomy

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine

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