Early Deterioration After Modified Rotational Acetabular Osteotomy for the Dysplastic Hip

Abstract

We performed a modified, rotational acetabular osteotomy through a lateral transtrochanteric approach on 19 hips in 18 patients with a dysplastic joint. Six hips in six patients were operated on using the original approach. The mean age at operation was 28 years (14 to 54) and the mean period of follow-up 2.3 years (1 to 4.4).Clinical evaluation using the Merle d'Aubigné score showed excellent or good results in 76%. Radiologically, 15 hips showed good acetabular remodelling and no signs of progressive osteoarthritis. In ten hips (40%) there was chondrolysis and collapse of the transferred acetabulum or both within one year, although this gave only mild pain in some patients. Factors which were significantly associated with the grade of outcome included age at the time of operation, the thickness of the transferred acetabulum, failure to use a bone graft, and a transtrochanteric approach.

Curved periacetabular osteotomy for the dysplastic hip: cadaveric and radiological analyses of safe procedures

“…The minimum distance to the margin of the circular hole from the intersection point of the arcuate line and the line passing from the proximal end of the anteroinferior iliac spine to that of the ischial spine was 10.6 mm (SD=3.3 mm); the bone thickness here seems adequate for avoiding postoperative necrosis of the acetabular fragment [14]. On the arcuate line, the C-shaped line should pass above the intersection point described earlier with Fig.…”

Total Hip Arthroplasty after Previous Acetabular Osteotomy: Comparison of Three Types of Acetabular Osteotomy

“…The posterior wall tended to show defects even after successful RAO because the osteotomized acetabular fragment was anteriorly and laterally rotated. Moreover, necrosis of the acetabular fragment [25] and early deterioration [26] following RAO have been previously reported. If the moved osteotomized acetabular fragment collapsed, the femoral head migrated proximally, and the anterior and posterior walls were defective at the level of the original acetabulum (Figs.…”

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

“…The specific techniques for obtaining these radiographic views have been previously published [6]. From the AP pelvis image the lateral center edge angle (LCEA) [39] and acetabular index (AI) [22,24] angle can be measured. The false-profile view allows examination of anterior coverage by measuring the anterior center edge angle (ACEA) [19].…”