Triple pelvic osteotomy: Report of our mid-term results and review of literature

Table 1 Pre-operative angle values and scores of all cases

	Age, yr	CE angle	Acetabular index	Sharp angle	AHI	HLI	JOAS	HHS
Case 1	19	-9	31	48	44.2	0.63	63	70
Case 2	20	13	20	46	65.8	0.54	73	80
Case 3	27	5	20	45	57.8	0.71	52	59
Case 4	29	9	19	45	60.0	0.69	52	59
Case 5	43	16	14	47	70.5	0.65	80	93
Case 6	43	0	26	54	52.2	0.56	54	73

CE angle: Center-edge angle; AHI: Acetabular head index; HLI: Head lateralization index; JOAS: Japanese Orthopedic Association score; HHS: Harris hip score.

Table 2 Post-operative angle values and scores of all cases

	CE angle	Acetabular index	Sharp angle	AHI	HLI	JOAS	HHS
Case 1	25	9	26	80.0	0.52	95	100
Case 2	53	-1	12	97.7	0.63	95	100
Case 3	10	15	36	66.7	0.70	91	100
Case 4	21	15	37	73.9	0.70	91	100
Case 5	26	2	35	80.0	0.70	88	96
Case 6	18	9	35	72.3	0.65	78	96

CE angle: Center-edge angle; AHI: Acetabular head index; HLI: Head lateralization index; JOAS: Japanese Orthopedic Association score; HHS: Harris hip score.

Table 3 The mean values of pre-operative and post-operative angles and scores

	Pre-op (mean ± SD)	Post-op (mean ± SD)	P value
CE angle	5.67 ± 8.26	25.5 ± 13.4	0.01841
Acetabular index	21.7 ± 5.44	6.33 ± 9.0	0.00981
Sharp angle	47.5 ± 3.09	30.2 ± 9.0	< 0.00011
AHI	58.4 ± 8.60	78.4 ± 9.8	0.00631
HLI	0.63 ± 0.06	0.65 ± 0.1	0.6286
JOAS	62.3 ± 10.9	89.7 ± 6.5	0.00061
HHS	72.3 ± 11.9	98.7 ± 1.9	0.00061

CE angle: Center-edge angle; AHI: Acetabular head index; HLI: Head lateralization index; JOAS: Japanese Orthopedic Association score; HHS: Harris hip score.

¹P < 0.05 based on a Student’s t-test.

Table 4 The advantages and demerits of triple osteotomy

Advantages	Demerits
EAsier than Bernese osteotomy or RAO	Risk of non-union of pubis and ischium
Applicable regardless of whether the triradiate cartilage remains fused or not	Require the long period before weight bearing
Low risk	Difficulty and limitation of sufficient acetabular correction and femoral head medicalization
Osteonecrosis of acetabulum
Major vessel injury
No shortening of lower limb	Possibly narrowing the pelvic cavity for childbirth

RAO: Rotational acetabular osteotomy.