EP1.32 Acetabular behaviour after containment and coverage procedure, are we witnessing remodelling?

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ID: 331335
2026
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Abstract
Abstract Background Corrective and containment osteotomies are commonly used in pediatric and adolescent hip disorders such as developmental dysplasia of the hip (DDH) and Legg–Calvé–Perthes disease (LCPD) to restore joint congruency and improve load distribution. Although postoperative remodeling is frequently observed during growth, the relative contribution of the femoral and acetabular compartments and the influence of skeletal maturity on this process remain poorly defined. The aim of this study was to quantitatively evaluate femoral and acetabular remodeling over time following hip corrective and containment procedures. Methods A retrospective study was conducted on 18 patients (20 hips) aged ≤16 years affected by LCPD, congenital dysplasia/dislocation, or osteonecrosis and treated with femoral osteotomies and periacetabular osteotomy. Anteroposterior pelvic radiographs were re-evaluated at standardized follow-up time points, from the preoperative stage to the last available follow-up. For each radiographic parameter, comparisons were made both between the preoperative and final follow-up measurements and between each intermediate control and the final follow-up, in order to identify the period during which remodeling was most concentrated. Changes were also compared between patients with an open versus closed triradiate cartilage, and the correlation between age and degree of remodeling was analyzed. Results Postoperative remodeling was significant and more pronounced at the acetabular level than in the femoral compartment. Longitudinal analyses showed that most changes occur within the first months after surgery, while parameters tend to stabilize at later follow-ups. Patients with open triradiate cartilage demonstrated greater remodeling, almost entirely involving the acetabulum, whereas the femoral response was more limited and essentially similar in both groups. Age showed a negative correlation with overall remodeling, suggesting a reduction in plasticity with skeletal maturation. Conclusions Remodeling after corrective and containment osteotomy occurs predominantly during the early phases of follow-up and is more evident on the acetabular side, particularly in patients with greater growth potential. Although the limited sample size and retrospective design do not allow definitive operative recommendations, these findings help clarify the dynamics of joint adaptation during growth and highlight the need for larger prospective studies integrated with clinical and functional outcomes.
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Authors Riccardo Giai Via, Matteo Giachino, Alessandro Massè
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.216
URL
https://doi.org/10.1093/jhps/hnag043.216
Keywords Keywords not found

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