Radiological follow-up of hip development after pelvic osteotomy in patients with developmental hip dislocation

Purpose: In this study, the relationship of long-term radiological changes after Pemberton osteotomy with the development of the acetabulum will be examined. Materials and Method: This is a retrospective study conducted to check and radiologically evaluate the long-term hip development of patients diagnosed with hip dislocation and treated with Pemberton osteotomy. Patients who applied to Harran University Faculty of Medicine Orthopedics and Traumatology outpatient clinic and underwent Pemberton osteotomy will be identified. Acetabular index (AI), average acetabular depth index, center edge angle, Tönnis, Kalamchi-MacEwen classification at preoperative and postoperative final follow-up of the patients will be examined and recorded. Patients will be examined and their flexion and abduction degrees will be recorded. Patients whose surgery period has been at least 5 years old will be called for a check-up, control pelvic radiographs will be taken and radiological measurements will be taken. Additionally, physical examinations will be performed and joint range of motion will be recorded. Findings: A total of 79 patients; 26.71% were operated bilaterally and 63.29% were operated unilaterally. 13.92% of the patients were male and 86.08% were female. A total of 108 hips underwent Pemberton osteotomy. Shortening osteotomy was performed on 25 femurs. Revision operations were performed on 6 hips that needed revision. 14.81% of the operated hips in the preoperative period were Tönnis grade 2; 21.30% grade 3; 63.89% were grade 4 stage. In the postoperative period, 92.59% were found to be Tönnis grade 1 and 7.41% were hip grade 2. According to the Kalamchi-Macewen classification, there was no avascular necrosis (AVN) in 56.48%. 20.37% of the hips were grade 1, 12.96% were grade 2, 5.56% were grade 3, and 5.4.63% were grade 4. The median postoperative CEA of the patients was 31 (9, 62); AI1 median 40 (26, 60); AI2 median 20 (6, 41); ASI1 median 15 (6, 38); ASI2 median 35 (20, 53); Reimer1 median 100 (40, 100); Reimer2 median was found to be 0 (0, 35). Conclusion: In cases where Pemberton osteotomy was performed, preoperative AI levels were found to be higher than postoperative AI levels, consistent with the literature. Postop ASI levels of the cases were found to be significantly higher than preoperative ASI levels. Postoperative Reimer levels of the cases were found to be significantly lower than preoperative Reimer levels. AI, ADI, CEA and Reimer markers can be monitored to follow the development of the acetabulum in cases where Pemberton osteomy is performed. Keywords: Developmental Hip Dysplasia, Pemberton, Osteotomy, Radiological Indexes