PubMed · 4081596
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D Bauer-Vinassac, C J Menkès, H Carter, P Benamou. [Cotyloid osteitis simulating chronic coxopathy].. https://pubmed.ncbi.nlm.nih.gov/4081596/
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This anatomical study concerns the arterial supply of the human acetabulum. The purpose is to contribute to prevention of postoperative necrosis of the acetabular bone fragment after rotational acetabular osteotomy (RAO). The arterial supply of the acetabulum was determined using a corrosion casting method. The acetabular branch of the obturator artery supplies the acetabulum through the acetabular notch. The pubic branches supply the pelvic surface of the acetabulum. Deep branches of the superior gluteal artery supply the superior region and the inferior gluteal artery supplies the postero-inferior region. From these results, we recognized that the important artery for achieving successful RAO is the acetabular branch of the obturator artery that supplies the acetabulum through the acetabular notch.
Between April 1984 and December 1987 a Müller acetabular reinforcement ring was employed in 98 revision cases (94 patients). Twenty-two patients died before follow-up evaluation. Forty-seven (66%) of the remaining 72 patients (49 of 75 hips) were examined after a mean of 6.4 years (range 5-9 years). Excluding those who died, the postoperative outcome of 69 patients is known. Migration was measured according to Sutherland by means of a digitising table. Cup position was determined by a new angle (beta) between the sacroiliacal line and a reference line. The reference line connects the centre of the femoral head with the intersection between the sacroiliacal and obturator lines. Aseptic and septic loosening required revision surgery in 2 cases each (4%). The postoperative beta angle showed a high correlation with migration (P = 0.001) as well as with radiolucencies (P = 0.001). In cases which required further revision, beta amounted to 44 deg (craniolateral position), and in stable cases up to 60 deg. A lateral and cranial position of a Müller acetabular reinforcement ring leads to high loosening rates. The beta angle accurately describes cup position, and its postoperative value is highly predictive for loosening.
We investigated the morphological changes in the articular cartilage after rotational acetabular osteotomy in 16 adolescent rabbits. Radiological and histological studies were conducted at 12 and 24 weeks postoperatively. The radiological evaluations at 12 and 24 weeks showed significantly increased femoral head coverage. No cases of osteonecrosis of the acetabulum or femoral head nor narrowing of the joint space was observed. The histology of the articular cartilage at 12 weeks postoperatively showed cloning and hypercellularity of the chondrocytes in the medial portion of the acetabular roof, indicating remodelling due to the increased weight-bearing stress caused by the osteotomy. The histology at 24 weeks postoperatively showed less cloning of the chondrocytes, indicating that the remodelling process in the articular cartilage induced by this procedure was almost complete at 24 weeks. Degeneration of the articular cartilage was not observed within 24 weeks of the operation.