{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T15:57:33Z","timestamp":1777564653064,"version":"3.51.4"},"reference-count":24,"publisher":"Georg Thieme Verlag KG","issue":"04","license":[{"start":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T00:00:00Z","timestamp":1693353600000},"content-version":"vor","delay-in-days":29,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev Bras Ortop (Sao Paulo)"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:title>Resumo<\/jats:title><jats:p>\n          Objetivo\u2003Investigamos o efeito do est\u00e1gio da doen\u00e7a, idade do paciente e contorno final da cabe\u00e7a femoral no contorno do acet\u00e1bulo ap\u00f3s a osteotomia derrotat\u00f3ria varizante (VDRO) do f\u00eamur proximal na doen\u00e7a de Perthes unilateral.<\/jats:p><jats:p>\n          M\u00e9todos\u2003O estudo \u00e9 uma an\u00e1lise retrospectiva de prontu\u00e1rios de 23 crian\u00e7as com idade \u2265 6 anos com doen\u00e7a de Perthes unilateral que foram submetidas ao procedimento prim\u00e1rio de VDRO para conten\u00e7\u00e3o. O \u00edndice acetabular (AI) e o \u00e2ngulo da borda central (CEA) foram calculados bilateralmente em radiografias pr\u00e9-operat\u00f3rias e de acompanhamento e submetidos \u00e0 compara\u00e7\u00e3o estat\u00edstica.<\/jats:p><jats:p>\n          Resultados\u2003Os pacientes eram 15 meninos e oito meninas. \u00c0 VDRO, seis quadris estavam no est\u00e1gio de Waldenstr\u00f6m modificado Ib, oito no est\u00e1gio IIa e nove no est\u00e1gio IIb. A m\u00e9dia de idade \u00e0 interven\u00e7\u00e3o cir\u00fargica foi de 8,7 anos. A dura\u00e7\u00e3o m\u00e9dia do acompanhamento foi de 3,5 anos. Todas as cabe\u00e7as femorais estavam consolidadas no \u00faltimo acompanhamento e os graus finais de Stulberg foram I\u2009=\u20093, II\u2009=\u20098, III\u2009=\u20097 e IV\u2009=\u20095. Havia displasia acetabular significativa do lado acometido no per\u00edodo pr\u00e9-operat\u00f3rio. No acompanhamento, os pacientes operados apresentaram eleva\u00e7\u00e3o significativa de AI e redu\u00e7\u00e3o de CEA. N\u00e3o houve remodelamento acetabular significativo nos quadris acometidos durante o acompanhamento, mesmo em crian\u00e7as operadas em idade menor (&lt; 8 anos) ou est\u00e1gios iniciais (est\u00e1gio Ib ou IIa). O remodelamento do acet\u00e1bulo tamb\u00e9m n\u00e3o correspondeu ao grau final de Stulberg.<\/jats:p><jats:p>\n          Conclus\u00e3o\u2003A VDRO do f\u00eamur do quadril acometido n\u00e3o levou \u00e0 melhora significativa da displasia acetabular, mesmo quando a cirurgia foi realizada nos est\u00e1gios iniciais da doen\u00e7a ou em pacientes mais jovens. Altera\u00e7\u00f5es acetabulares residuais tamb\u00e9m foram observadas mesmo com graus de Stulberg favor\u00e1veis.<\/jats:p>","DOI":"10.1055\/s-0043-1772242","type":"journal-article","created":{"date-parts":[[2023,8,30]],"date-time":"2023-08-30T22:32:40Z","timestamp":1693434760000},"page":"e639-e645","source":"Crossref","is-referenced-by-count":1,"title":["O acet\u00e1bulo sofre remodelamento ap\u00f3s a osteotomia derrotat\u00f3ria varizante em pacientes com doen\u00e7a de Perthes?"],"prefix":"10.1055","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6974-5199","authenticated-orcid":false,"given":"Nitish Bikram","family":"Deo","sequence":"additional","affiliation":[{"name":"M\u00e9dico Ortopedista, Hospital Universit\u00e1rio Tribhuvan, Maharajgunj Medical Campus, Instituto de Medicina, Maharajgunj, Kathmandu, Nepal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8646-0926","authenticated-orcid":false,"given":"Anil","family":"Agarwal","sequence":"additional","affiliation":[{"name":"M\u00e9dico Ortopedista, Departamento de Ortopedia Pedi\u00e1trica, Chacha Nehru Bal Chikitsalaya, Geeta Colony, Delhi, I\u00cdndia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2023,8,30]]},"reference":[{"issue":"03","key":"ref1","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1097\/01241398-199205000-00006","article-title":"Acetabular remodelling in Perthes' disease after primary healing","volume":"12","author":"M Kamegaya","year":"1992","journal-title":"J Pediatr Orthop"},{"issue":"03","key":"ref2","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1097\/01.bpo.0000221926.10148.bf","article-title":"The role of the acetabulum in Perthes disease","volume":"26","author":"A Grzegorzewski","year":"2006","journal-title":"J Pediatr Orthop"},{"issue":"07","key":"ref3","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1097\/BPO.0b013e31818456dc","article-title":"To what extent does remodeling of the proximal femur and the acetabulum occur between disease healing and skeletal maturity in Perthes disease? 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