Abstract
Hip dysplasia is a developmental disorder that results in anatomic abnormalities in which the acetabular coverage is insufficient. In the absence of severe degenerative changes, younger active patients with these symptomatic structural abnormalities are increasingly managed with joint-preserving operations. Historically there have been numerous reconstructive pelvic osteotomies. In recent years, the Bernese periacetabular osteotomy (PAO) has become the preferred osteotomy by many surgeons. Even so, as our understanding of the hip advances and new diagnostic and treatment techniques are developed, we sought to put a focus on the long-term results of augmental osteotomies and pelvic osteotomies other than the PAO, to see if any of these surgeries still have a place in the current algorithm of treatment for the dysplastic hip. As the longevity of the treatment is the focal point for joint preservation surgeries for the dysplastic hip, these authors have searched databases for articles in the English literature that reported results of long-term follow-up with a minimum of 11-year survivorship after surgical treatment of developmental dysplasia of the hip. Reconstruction osteotomies for the dysplastic hip are intended to restore normal hip anatomy and biomechanics, improve symptoms and prevent degenerative changes, in this manuscript each procedure is independently assessed on the ability to achieve these important characteristics.
Highlights
Hip dysplasia is a developmental disorder that results in anatomic abnormalities in which the acetabular coverage is insufficient, predisposing the hip joint to have increased contact pressure on the cartilage as well as instability which leads to damage to the soft tissue structures surrounding the joint, eventually leading to coxarthrosis
As our understanding of the hip advances and new diagnostic and treatment techniques are developed, we sought to put a focus on the long-term results of augmental osteotomies and pelvic osteotomies other than the periacetabular osteotomy (PAO), to see if any of these surgeries still have a place in the current algorithm of treatment for the dysplastic hip
It can be observed that at the expense of some increase in invasiveness, the PAO has evolved to achieve many of these theoretical ideals, becoming the current gold standard in the treatment of the dysplastic hip in the skeletally mature patient
Summary
1. Department of Orthopaedic Surgery, Kyoto University, Kyoto 606-8507, Japan 2. Chair of Department of Orthopaedic Surgery, Kyoto University, Graduate School of Medicine, Kyoto 606-8507, Japan 4. Professor of Sports Medicine and Arthroscopy, Department of Orthopaedic Surgery, Stanford School of Medicine, Stanford, CA 94063, USA
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