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Comparison of Pemberton Osteotomy and Kalamchi Modification of Salter Osteotomy in the Treatment of Developmental Dysplasia of the Hip

Background: Several pelvic osteotomy techniques are introduced for the treatment of Developmental Dysplasia of the Hip (DDH). However, there is no agreement on the optimal pelvic osteotomy in DDH. Thus, this study aimed to compare the outcomes of Pemberton Osteotomy (PO) and the Kalamchi Modification of Salter Osteotomy (KMSO). Objectives: Comparison of pemberton osteotomy and kalamchi modification of salter osteotomy in the treatment of developmental dysplasia of the hip. Methods: In a retrospective study, radiographic and clinical outcomes as well as surgical complications were compared between the patients who underwent unilateral DDH surgery using either KMSO or PO. The radiographic measures included the assessment of the acetabular index and the Shenton line. The clinical results of the osteotomies were evaluated by McKay’s criteria modified by Berkeley et al. Also, Kalamchi and MacEwen’s classification was used for the assessment of avascular necrosis. Results: The characteristic features of the patients, such as age and follow-up time, were statistically comparable between the two study groups. One year after the surgery, the Shenton line was intact in 55 patients (84.6%) of the KMSO group and 40 patients (88.9%) of the PO group (P=0.52). The Mean±SD value of the acetabular index was 21.1±5.1 and 20.7±3.9 in the KMSO and PO groups, respectively (P=0.13). Besides, the McKay’s clinical criteria were respectively excellent, good, and fair in 44, 16, and 5 patients (67.7%, 24.6%, and 7.7%, respectively) of the KMSO group, and 31, 12, and 2 patients (70%, 26.6%, and 4.4%, respectively) of the PO group (P=0.4). Moreover, the number of postoperative avascular necrosis did not significantly differ between the two study groups. Conclusion: The PO and KMSO techniques are equally safe and effective osteotomies in the treatment of DDH and can be used interchangeably.