Contemporary Concepts in the Young Adult Hip Patient: Periacetabular Osteotomy for Hip Dysplasia

Coobs, Benjamin R.; Xiong, Ao; Clohisy, John C.

doi:10.1016/j.arth.2015.02.045

Cited by 35 publications

(28 citation statements)

References 41 publications

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“…In fact, 20% to 40% of patients with osteoarthritic hips have a history of dysplasia. 11 , 12 Female sex and familial antecedents are known risk factors. The necessity for total hip arthroplasty at a relatively young age is a concern in terms of implant durability and stability, 20 and the likelihood of a more difficult and unpredictable revision surgical procedure may be as much as 25% higher compared with the general population.…”

Section: Discussionmentioning

confidence: 99%

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Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia

Maldonado

LaReau

Lall

et al. 2018

Arthroscopy Techniques

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In the setting of true hip dysplasia, the high prevalence of intra-articular pathology may lead to recurrent symptoms and failure after periacetabular osteotomy (PAO). Femoral neck osteochondroplasty, microfracture, removal of loose bodies, and labral repair are examples of procedures that are performed with concomitant arthroscopy. When damage to the labrum is too severe to repair, reconstruction instead of extensive debridement before PAO can be more effective in restoring the labral seal to maintain joint lubrication and chondral protection. This Technical Note describes a method for concomitant hip arthroscopy with circumferential labral reconstruction with allograft and PAO.

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Section: Discussionmentioning

confidence: 99%

“… 8 , 9 Bony correction with PAO is the fundamental base for the treatment of true hip dysplasia. 10 , 11 , 12 However, the authors have also advocated concomitant arthroscopy for the treatment of intra-articular derangements. 2 , 6 , 13 , 14 …”

mentioning

confidence: 99%

Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia

Maldonado

LaReau

Lall

et al. 2018

Arthroscopy Techniques

View full text Add to dashboard Cite

show abstract

“…Patterns and location of symptoms as well as compensatory peri-articular adaptations are often reflective of the specific anatomic region of structural instability. 24 Uncorrected symptomatic acetabular dysplasia may increase the risk of functional impairment and degenerative joint disease due to associated labral hypertrophy and pathology, bony impingement, and capsular attenuation. 25 , 30 , 37 , 54 , 81 Previous studies have linked acetabular dysplasia to premature osteoarthritis and the increased likelihood of requiring arthroplasty.…”

Section: Pathophysiologymentioning

confidence: 99%

“…The Bernese peri-acetabular osteotomy (PAO), 24 often referred to as the Ganz osteotomy, is currently the preferred technique for large-scale correction of acetabluar dysplasia. 1 , 39 It has been championed for its ability to affect global improvement in femoral head coverage and balance force concentration through the weightbearing portion of the femoral head.…”

Section: Joint-preserving Techniquesmentioning

confidence: 99%

Current Concepts in Hip Preservation Surgery

et al. 2015

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Context:An evolution in conceptual understanding, coupled with technical innovations, has enabled hip preservation surgeons to address complex pathomorphologies about the hip joint to reduce pain, optimize function, and potentially increase the longevity of the native hip joint. Technical aspects of hip preservation surgeries are diverse and range from isolated arthroscopic or open procedures to hybrid procedures that combine the advantages of arthroscopy with open surgical dislocation, pelvic and/or proximal femoral osteotomy, and biologic treatments for cartilage restoration.Evidence Acquisition:PubMed and CINAHL databases were searched to identify relevant scientific and review articles from January 1920 to January 2015 using the search terms hip preservation, labrum, surgical dislocation, femoroacetabular impingement, peri-acetabular osteotomy, and rotational osteotomy. Reference lists of included articles were reviewed to locate additional references of interest.Study Design:Clinical review.Level of Evidence:Level 4.Results:Thoughtful individualized surgical procedures are available to optimize the femoroacetabular joint in the presence of hip dysfunction.Conclusion:A comprehensive understanding of the relationship between femoral and pelvic orientation, morphology, and the development of intra-articular abnormalities is necessary to formulate a patient-specific approach to treatment with potential for a successful long-term result.

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“… 17 , 18 , 19 Nevertheless, PAO alone or with the addition of hip arthroscopic surgery remains a challenging procedure, and experienced hands are needed to avoid catastrophic complications. 20 , 21 In addition, long recovery periods may be unappealing for some patients.…”

mentioning

confidence: 99%

Modified Shelf Acetabuloplasty Endoscopic Procedure With Allograft for Developmental Hip Dysplasia Treatment

Maldonado

Ortiz-Declet

Chen

et al. 2018

Arthroscopy Techniques

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Hip dysplasia has been identified as one of the leading causes of osteoarthritis. However, hip arthroscopy alone, in the setting of hip dysplasia, remains controversial. In borderline hip dysplasia, with lateral center-edge angle (LCEA) between 18° and 25°, good outcomes have been reported with appropriate capsular and labral management. However, in severe hip dysplasia, with LCEA below 18°, there is an acetabular bony structural deficiency that must be addressed. Even with the potential benefit of hip arthroscopy in addressing intra-articular injuries related to the instability, it cannot be used for soft-tissue procedures. Periacetabular osteotomy remains the gold standard to address that matter; however, its invasive nature along with the long recovery time leaves some patients unwilling to undergo this procedure. New minimally invasive endoscopic procedures, derived from open techniques, describe acetabular autologous bone grafting as an alternative. Donor-side morbidity is always a concern when using autografts; we believe that the use of bone allograft will decrease this potential issue and make the procedure itself less invasive. This Technical Note will describe a type of endoscopic shelf acetabuloplasty using an allograft iliac bone graft.

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Contemporary Concepts in the Young Adult Hip Patient: Periacetabular Osteotomy for Hip Dysplasia

Cited by 35 publications

References 41 publications

Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia

Concomitant Arthroscopy With Labral Reconstruction and Periacetabular Osteotomy for Hip Dysplasia

Current Concepts in Hip Preservation Surgery

Modified Shelf Acetabuloplasty Endoscopic Procedure With Allograft for Developmental Hip Dysplasia Treatment

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