Periacetabular Osteotomy for Stabilization of Recurrent Post-Traumatic Dislocation of the Hip

Abstract

This article reports on the case of a twenty-eight-year-old woman who developed recurrent hip dislocation after open reduction and internal fixation of a posterior wall hip fracture-dislocation with an associated femoral head fracture. Because of the posterior wall deficiency, a modified periacetabular osteotomy was performed to stabilize the hip. At the two-year follow-up, there was no evidence of osteonecrosis in the remaining femoral head and the joint space was maintained. There has been no recurrence of dislocation. This procedure may be indicated in a patient with an unreconstructable posterior wall deficiency and persistent instability after a traumatic hip dislocation.

Acetabular Retroversion and Decreased Posterior Coverage Are Associated With Sports-related Posterior Hip Dislocation in Adolescents

“…In this setting, the morphology of the acetabulum should be investigated to include assessment of the acetabular version measured at the center of the femoral head and cranially and also the coverage of the femoral head anteriorly and posteriorly by the acetabular sector angles. In select patients, a periacetabular osteotomy to correct acetabular retroversion and improve the posterior coverage has been reported to provide joint stability [3,7]. Our study showed an association between acetabular retroversion and decreased posterior coverage with sports-related posterior hip dislocation in adolescents.…”

Recurrent Post-traumatic Posterior Hip Dislocation Treated Using a Bone Block Technique

“…The patient's compliance to postoperative restrictions is vital, with an unacceptable rate of postop-erative posterior column fractures with early weight-bearing 27 . Crowther et al presented the use of this technique with a successful outcome at 24 months 28 . Arpey et al reported using a PAO in the acute stage for a patient who has had posterior rim fracture and femoral head fracture-dislocation.…”

Recurrent Posterior Dislocation of the Hip Treated with Periacetabular Osteotomy

“…In this setting, the literature indicates the important role of the capsule and labrum in maintaining the stability of the hip joint [3][4][5][6][7][8][9][10][11][12][13][14][15] . There is substantial controversy regarding the optimal method for the treatment of this uncommon disorder.…”

“…They thought that the complications may have resulted from the operative intervention to repair the hip joint capsule and emphasized the need for a careful and thorough evaluation and treatment of this syndrome. Crowther et al reported the case of a patient who had recurrent hip dislocation after open reduction and internal fixation of the posterior wall and femoral head fractures 11 . Because of the posterosuperior wall deficiency, a modified periacetabular osteotomy was performed.…”