Modified periacetabular osteotomy technique in the management of acetabular dysplasia

Abstract

Purpose: Evaluating the results of modified PAO in the management of acetabular dysplasia. Patients and Methods: This prospective study included 13 cases. All cases were diagnosed with acetabular dysplasia then treated by PAO using our modified technique. In all included patients, the retro-acetabular cut was performed before the ischial cut during PAO surgery. Eight cases were stage IV and five were stage III according to Severin classification. The mean preoperative HHS was 83 points. The mean preoperative acetabular angle of Sharp value was 49 degrees. The mean preoperative LCEA value was 12 degrees. Results: The mean postoperative HHS at the final follow up was 87 points. The mean postoperative acetabular angle of Sharp value was 37 degrees. The mean postoperative LCEA value was 32 degrees. According to HHS score, six cases had excellent results, six had good results, and one case had fair outcome. Lateral femoral cutaneous nerve neuropathy occurred in two patients, and superficial wound infection was encountered in one patient.Conclusion: Performing the retro-acetabular cut before the ischial cut prevented posterior column fracture Interruption in all cases, making PAO safer and easier to perform, and reducing its risk.