Periacetabular osteotomy in patients with Down’s syndrome

Abstract

We treated eight dysplastic acetabula in six skeletally mature patients with Down's syndrome by a modified Bernese periacetabular osteotomy. The mean age at the time of surgery was 16.5 years (12.8 to 28.5). Mean length of follow-up was five years (2 to 10.4).Pre-operatively the mean (Tonnis) acetabular angle was 28 degrees, the centre-edge angle was -9 degrees, and the extrusion index was 60%; post-operatively they were 3 degrees, 37 degrees, and 17%, respectively. Two patients with post-operative (Tonnis) acetabular angles > 10 degrees developed subluxation post-operatively and required secondary varus derotation femoral osteotomies. Another patient developed a late labral tear which was treated arthroscopically. All eight hips remain clinically stable, and are either asymptomatic or symptomatically improved. These results suggest that the modified Bernese periacetabular osteotomy can be used successfully in the treatment of acetabular dysplasia in patients with Down's syndrome.

Bernese Periacetabular Osteotomy in Males: Is There an Increased Risk of Femoroacetabular Impingement (FAI) After Bernese Periacetabular Osteotomy?

“…The senior authors' average rate has been 15 % after PAO [13,18,[21][22][23]; thus, the occurrence of adverse events in this solely male population was high. The high rate of adverse events after PAO in males is clear.…”

Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery

“…The Bernese PAO was first described by Ganz et al [11] in 1988 for treatment of acetabular dysplasia and hip subluxation and has since been established as an effective reconstructive procedure for correcting hip dysplasia of varying etiologies [4,5,15,18,27,29,40,41]. The advantages of this technically demanding surgery include preservation of the posterior column allowing immediate postoperative mobilization, the ability to medially translate the joint center, and preservation of the size and shape of the true pelvis [3,11,[40][41][42].…”

Endoscopy-assisted Periacetabular Osteotomy

“…Open surgical technique and internal fixation of PAO is an accepted procedure in the treatment of acetabular dysplasia [2,4,5,9,12,13]. Compared with the conventional open surgical technique, endoscopic techniques typically minimize the soft tissue damage caused by the surgical approach.…”