Osteotomies Around the Hip Joint

Chang, Jae Suk; Kim, Ji Wan

Abstract

The goal of an osteotomy around the hip joint for treating hip dysplasia is to delay or prevent osteoarthritis by reducing the stress to the hip joint. This can be archived with anterolateral displacement of the acetabulum and an osteotomy around the hip joint is indicated for the young and active patients, besides performing total hip arthroplasty. As the osteotomy site is close to the hip joint, we can obtain more correction with performing this type of surgery than is possible with other types of pelvic osteotomies and we can get excellent radiological and clinical outcomes. But periacetabular rotational osteotomy is a rather difficult procedure, there may be complications and a long learning curve is needed to learn the surgical technique. A dual approach for periacetabular rotational osteotomy is easier with direct exposure of the osteotomy site and there are fewer complications than that with performing a Berneses periacetabular rotational osteotomy, as described by Ganz. Therefore, it is recommended for beginners. The osteotomy site of the proximal femur is usually around the lesser trochanter, but femoral neck osteotomy may be performed in rare cases. The preoperative planning for obtaining a correction angle of the osteotomy site is the most important factor, and excellent results can be archived by performing an accurate procedure.