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Polygonal triple (Kotz) osteotomy (over 10 years experience)

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Abstract

We evaluated the results of polygonal triple (Kotz) osteotomy for the treatment of acetabular dysplasia over 10 years. This study included 31 hips of 27 patients who had the Kotz osteotomy for acetabular dysplasia. The mean age was 21.5 years. We performed the original Kotz osteotomy for the first 22 hips (group I), while the modified Kotz osteotomy through an intra-pelvic approach without damage to the abductor muscle was applied for the last 9 hips (group II). Patients were evaluated by clinically and radiologically. The average follow-up was 106 months in group I, and 18 months in group II. The Trendelenburg gait was unchanged for four patients in group I and for one patient in group II. The Harris Hip Score improved in all patients postoperatively. Radiographic assesment showed improvement in both groups in terms of the angle of CE, VCE, and Sharp postoperatively(P<0.05). The complication rate per hip was 0.29. The original Kotz osteotomy achieves adequate coverage for the treatment of acetabular dysplasia, and patients are generally satisfied by this procedure. Nonetheless, the modified Kotz osteotomy provides recovery of the abductor muscle strength in the early postoperative period and subsequently decreases the rate of the Trendelenburg gait compared to the original Kotz osteotomy.

Résumé

Nous avons évalué le résultat de l’ostéotomie de Kotz dans le traitement des dysplasies acétabulaires sur une période de 10 ans. Cette étude a inclus 31 hanches chez 27 patients. L’âge moyen était de 21.5 ans. Nous avons réalisé la technique originale de Kotz pour 22 patients (groupe 1) et la technique de Kotz modifiée chez 9 patients (groupe 2). Les patients ont été évalués sur le plan clinique et radiologique. Le suivi moyen a été de 106 mois pour le groupe 1 et de 18 mois pour le groupe 2. Une boiterie de type Trendelenbourg a persisté chez 4 patients du groupe 1 et 1 patient du groupe 2. Le score de Harris post opératoire a été amélioré chez tous les patients. L’amélioration radiographique a été constatée dans les deux groupes sur l’angle CE et VCE et l’angle de Sharp (P<0.05). Le taux de complication a été de 0.29. La technique originale de Kotz donne de bons résultats quant à la couverture de la hanche, cependant la technique de Kotz modifiée permet de récupérer plus rapidement une force importante des muscles abducteurs en post opératoire et ce fait diminue le pourcentage de patients présentant une boiterie de type Trendelenbourg.

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Authors and Affiliations

  1. Medical School of Gaziosmanpasa, University of Gaziosmanpasa, Tokat, Turkey

    Cengiz Sen, Taner Gunes & Mehmet Erdem

  2. Medical School of Istanbul, University of Istanbul, Istanbul, Turkey

    Harzem Ozger & I. Remzi Tozun

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  1. Cengiz Sen
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  2. Taner Gunes
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  3. Mehmet Erdem
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  4. Harzem Ozger
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  5. I. Remzi Tozun
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Correspondence to Cengiz Sen.

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Sen, C., Gunes, T., Erdem, M. et al. Polygonal triple (Kotz) osteotomy (over 10 years experience). International Orthopaedics (SICOT) 31, 279–285 (2007). https://doi.org/10.1007/s00264-006-0203-y

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