Article
Fixation stability and implant-associated complications in periacetabular osteotomy – a comparison of screw- and k-wire-fixation
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Authors
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Vincent Justus Leopold
- Charité - Universitätsmedizin Berlin, Centrum für Musculoskeletale Chirurgie, Klinik für Unfall- und Wiederherstellungschirurgie, Berlin, Germany
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Juana Lea Conrad
- CMSC, Charite, Berlin, Germany
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Robert Karl Zahn
- Charité - Universitätsmedizin Berlin, Klinik für Orthopädie, Centrum für Musculoskeletale Chirurgie, Berlin, Germany
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Christian Hipfl
- Charité - Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Berlin, Germany
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Carsten Perka
- Charité - Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Berlin, Germany
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Sebastian Hardt
- Charité - Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie, Klinik für Orthopädie, Berlin, Germany
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Vincent Leopold
- Centrum für Muskuloskelettale Chirurgie, Charite Berlin, Berlin, Germany
| Published: | October 26, 2021 |
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Outline
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Objective: The aim of this study was to compare the fixation stability and complications in patients undergoing periacetabular osteotomy (PAO) with either k-wire- or screws-fixation.
Methods: We performed a retrospective study to analyze a consecutive series of patients who underwent PAO with either screw- or k-wire fixation. Patients who were treated for acetabular retroversion or had previous surgery on the ipsilateral hip joint were excluded. 192 patients (196 hips: 98 K-wire/98 Screw fixation) were included. The mean age at the time of PAO was 29.3 years (16 to 48) in the k-wire group and 27.15 (15 to 45) in the screw group and 83.3% were female. Clinical parameters including duration of surgery, minor complications (soft-tissue irritation and implant migration) and major complications (implant failure and non-union) were evaluated. Radiological parameters including LCE, TA and FHEI were measured preoperatively, postoperatively and at 3-months follow-up.
Results and Conclusion: Duration of surgery was significantly reduced in the k-wire group with 88.2 min (53 to 202) compared to the Screw group with 119.7 min (50 to 261) (p<0.001). Soft tissue irritation occurred significantly more often in the K-wire group (72/98) than in the Screw Group (36/98) (p<0.001). No group showed significantly more implant migration than the other. No major complications were observed in either group. Postoperative LCE, TA and FHEI were improved significantly in both groups for all parameters (p=<0.0001). There was no significant difference for initial or final correction for the respective parameters between the two groups. Furthermore no significant difference in loss of correction was observed between the two groups for the respective parameters.
K-Wire fixation is a viable and safe option for fragment fixation in PAO with comparable stability and complication rates. An advantage of the method is the significantly reduced operative time. A disadvantage is the significantly higher rate of implant-associated soft-tissue irritation necessitating implant removal.
