Selective Osteotomy Combined With Anatomic Hip Restoration for Hartofilakidis B–C Hip Dysplasia: Long-Term Results
Bibliographic record
Abstract
AIMS: Reconstructing hips in moderate-to-severe developmental dysplasia of the hip (DDH) in adults, such as Hartofilakidis type B-C, presents a notable challenge. Despite various surgical procedures available, no approach has shown consistent long-term success. This observational study aimed to report the long-term survivorship and outcomes of a "selective osteotomy treatment algorithm," which involves selective osteotomy combined with anatomic hip restoration, for moderate-to-severe DDH. METHODS: We retrospectively reviewed 24 patients with Hartofilakidis type B (moderate) or C (severe) DDH who underwent total hip arthroplasty with selective osteotomy approach at Siriraj Hospital, Mahidol University, Thailand from 2001 to 2021. We employed a Kaplan-Meier curve to assess procedure survivorship, with revision surgery as the end point. Clinical, functional outcomes assessed with Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement score, complications, and radiological assessments during follow-up were recorded. RESULTS: The mean patient age was 56.8 ± 11.8 years (range 37 to 78 years), and mean height was 152.0 ± 11.7 cm (range 111 to 167 cm). The median surgical time was 84 minutes (range 50 to 300 minutes), with a median estimated blood loss of 450 mL (range 100 to 4000 mL). The median follow-up time was 7.8 years (range 4 to 21 years). The Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement score improved markedly from baseline, with a mean anchor-based increase of 23.70 ± 0.04 at 6 months postoperatively. Three cases encountered revision surgery due to osteotomy nonunion with stem fracture, early dislocation, and periprosthetic joint infection. The survival probability at 12 years was 83.7%. No sciatic nerve injuries were reported. No radiographic pathology was detected during follow-up. CONCLUSION: Selective osteotomy combined with anatomic hip restoration is a feasible and effective approach for managing moderate-to-severe DDH, as it demonstrated favorable long-term outcomes. Our approach may serve as a treatment option for patients with similar challenging deformities.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".