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Periacetabular osteotomy in patients with Down’s syndrome

Department of Orthopaedic Surgery, SUNY Upstate Medical University, 550 Harrison Street, Suite 128, Syracuse, New York 13202, USA.

Y.-J. Kim, MD, PhD, Assistant Professor; and M. B. Millis, MD, Associate Professor

Department of Orthopaedic Surgery, Children’s Hospital, 300 Longwood Avenue, Boston, Massachusetts 02115, USA.

Correspondence should be sent to Dr D. A. Katz; e-mail: katzdortho{at}aol.com

We treated eight dysplastic acetabula in six skeletally mature patients with Down’s syndrome by a modified Bernese periacetabular osteotomy. The mean age at the time of surgery was 16.5 years (12.8 to 28.5). Mean length of follow-up was five years (2 to 10.4).

Pre-operatively the mean (Tönnis) acetabular angle was 28°, the centre-edge angle was –9°, and the extrusion index was 60%; post-operatively they were 3°, 37°, and 17%, respectively. Two patients with post-operative (Tönnis) acetabular angles > 10° developed subluxation post-operatively and required secondary varus derotation femoral osteotomies. Another patient developed a late labral tear which was treated arthroscopically. All eight hips remain clinically stable, and are either asymptomatic or symptomatically improved.

These results suggest that the modified Bernese periacetabular osteotomy can be used successfully in the treatment of acetabular dysplasia in patients with Down’s syndrome.

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				M. S. Caird, B. P.D. Wills, and J. P. Dormans Down syndrome in children: the role of the orthopaedic surgeon. J. Am. Acad. Ortho. Surg., October 1, 2006; 14(10): 610 - 619. [Abstract] [Full Text] [PDF]