Introduction This report describes the operative indications and essential techniques of eccentric rotational acetabular osteotomy for hip dysplasia in patients with either pre-osteoarthritis, early arthritis, or in some cases even advanced osteoarthritis of the hip.
Step 1: Patient Positioning An accurate lateral decubitus position of the pelvis is important.
Step 2: Skin Incision Make a bikini skin incision and elevate the skin flap.
Step 3: Transtrochanteric Approach Make a Y-shaped incision, retract the innominate fossa, and detach the greater trochanter with an oscillating saw.
Step 4: Deep Dissection to Mark the Osteotomy Lines Partially release and divide the rectus femoris, detach the iliacus, and retract the iliopsoas.
Step 5: Osteotomy of Ilium and Ischium It is essential to use an osteotomy guide to perform an accurate spherical osteotomy.
Step 6: Osteotomy of the Pubic Bone The osteotomy of the pubic bone is technically demanding.
Step 7: Reorientation of the Acetabular Fragment The acetabular fragment can be rotated to the intended position as determined by the preoperative planning.
Step 8: Reattachment of the Greater Trochanter Fix the greater trochanter with two AO cancellous screws.
Step 9: Postoperative Care Walking with a walker and partial weight-bearing begins one day after surgery, and full weight-bearing starts at two months postoperatively.
Results The clinical and radiographic outcomes in the first 126 consecutive patients (132 hips) who had undergone eccentric rotational acetabular osteotomy at our institution were retrospectively assessed.
Pitfalls & Challenges
This report describes the operative indications and essential techniques of eccentric rotational acetabular osteotomy for hip dysplasia in patients with pre-osteoarthritis, early arthritis, or in some cases even advanced osteoarthritis of the hip.
Acetabular dysplasia is one of the most common causes of osteoarthritis of the hip1,2. Periacetabular osteotomy is an excellent procedure for young active patients …
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