Comparision of two methods of lateral shelf acetabuloplasty in the treatment for Legg-Calvé-Perthes Disease

Purpose: This retrospective study compares two methods of shelf acetabuloplasty between Staheli technique and Tectoplasty technique to evaluate the efficacy of different surgery in the treatment of Perthes disease in children. Methods: The study included 42 patients (35 boys and 7 girls) older than 7 years with Perthes disease was performed by shelf acetabuloplasty. There were 24 children (19 boys and 5 girls; mean months at the surgery of 80.63±10.88) performed by Staheli technique and 18 children (16 boys and 2 girls; mean months at the surgery of 81.38±15.59) performed by Tectoplasty technique. The data and radiographs of patients were retrospectively recorded and analyzed. The clinical outcomes at the final follow-up were evaluated by Stulberg classification at the last follow-up. Results: There were no significant statistical differences in the Herring and Catterall classification before surgery and the result of Stulberg classification at the follow-up between two groups (P>0.05). The containment of femoral head in hip was improved by surgery in two groups with the increase of Sharp angle and femoral head size ratio and the decrease of subluxation ratio of femoral head (P<0.05). The Staheli technique could provide more decrease of the subluxation ratio of femoral head with 74.38%±10.29% than Tectoplasty technique with 67.31%±6.87% (P=0.011). There was no significant statistical difference in the extent of decrease in Sharp angle between Staheli group of 77.12%±7.07% and Tectoplasty group of the 74.53%±5.21% (P=0.199), and no significant statistical difference in femoral head size ratio between Staheli group of 1.12±0.08 and Tectoplasty group of 1.17±0.07 (P=0.053). Conclusion: Both of Staheli and Tectoplasty technique of lateral shelf acetabuloplasty could promote the coverage of affected hip and remodeling of femoral head in the treatment of Perthes disease. The lateral acetabuloplasty represents a containment procedure that helps to reduce subluxation of the femoral head, thereby helping to restore the biomechanical function of the hip joint. Staheli technique could provide the more decrease in the subluxation ratio of femoral head than Tectoplasty technique.