Hip Pelvis.  2012 Sep;24(3):165-185. 10.5371/hp.2012.24.3.165.

Five Treatment Models of Dysplastic OA by the RAO

• Kang CS

• KMID: 2054130
• DOI: http://doi.org/10.5371/hp.2012.24.3.165

Abstract

No abstract available.

Figure

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  Fig. 1 Adapted from Ninomiya, Tagawa JBJS. 1984;65A:430-6.

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  Fig. 2 Drawings illustrating the grades of congruity of the hip joint (adapted from Bauer and Kerschbaumer). (A) Grade 1, (B) Grade 2, (C) Grade 3, (D) Grade 4.

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  Fig. 3 The resultant force acting on the hip joint in inpotal Monopodal stance phase.

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  Fig. 4 (A) CE: 8°ROA: 30°, (B) PO CE: 45°ROA: Horizontal, (C) 2007. 9 RAO 23ys (80ys).

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  Fig. 5 (A) ROA: 30°, CEA: 0°, (B) lateralized acetabulum (thick medial wall, shallow acetabular socket), (C) Do not cut through the Kohlers line, (D) Post op figure.

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  Fig. 6 (A) CE: 8°, (B) CE: 45°, ROA: reversed, medial shift, (C) 39ys PO 21y.

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  Fig. 7 (A) Pre op bilateral dysplatic hip, (B) Post op 22ys changed CEA. ROA mealige (22Y).

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  Fig. 8 (A) CE: -10°, ROA: 35°, (B) Curette out of bone, (C) CE: 45°, ROA: 0°. amount of medialization: 20 mm (2 cm).

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  Fig. 9 (A) CE: -16°(reversed), ROA: 30°, (B) IR & Reduction, (C) RAO, (D) CE: 45°, ROA: 0°, (E) Post op 10ys, (F) Post op 25ys.

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  Fig. 10 Focal cartilage defect of the femoral head (Modification of Marvin E. Steinberg. The hip and Its Disorders, W. B. Saunders company, 1991:9.53).

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  Fig. 11 (A) CE: 10°, multiple columnar head cysts, (B) ROA: 30°, (C) Minimal lateral over rotation and 10 mm anterior rotation, (D) Post op, (E) CE: 45°ROA: +6°, (F) RAO 22ys (2009. 11): multiple head cysts.

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  Fig. 12 (A) CE; 10°RAO 30°, (B) curtain, floor osteophytes, (C) CE: 45°, (D) Post op 15ys, reversed ROA, medial shift.

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  Fig. 13 (A) head cysts, capital drop, floor osteophytes, (B) Post op, ROA reversed; 35°CE; 45°, (C) Post op 20ys(87ys).

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  Fig. 14 Bilateral cystic necrosis. (A) A cystic lesion occupies 1/2 of head, (B) Open head window, (C) gross specimem: fibromucoid tissue. (D) After autogenouse cancellous bone graft, catilage suture with 3.0 vicril, expecting Osteoinduction, Osteoconduction. (E) 16ys later operation of curettage head cyst and fill-up autogenous bone graft, Early radiolund cystic kissing lesion lesions in lateral edge acetabulum and femoral head. (F) Performed RAO on R hip for the cystic lesion of the Acetabulum (current & BG). (G) post op 10ys.

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  Fig. 15 (A) coalesent cysitic necrosis in femoral head, (B) MRI.

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  Fig. 16 (A) by the over rotation of Actabulum. We can get the full containment and coverage of femoral head and adequet medilaization (OP 2001. 12), (B) PO 5ys. (53ys. 2006).

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  Fig. 17 2011. 3. F/U 10y. 58ys. He is very active Golfer, Cellist.

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  Fig. 18 (A), (B) head cysts, capital drop, curtain osteophytes, (C) illustration of adequete lateral rotation and 10 mm anterior rotation (D) Post op 5ys.

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  Fig. 19 (A), (B), (C), (D), (E), (F) multi-columnar cysts are persisted longer period 14ys.

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  Fig. 20 (A) MED bilateral hip 18ys girl. (C) PO bilateral 16ys.

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  Fig. 21 (A), (B) Bilateral cystic necrosis & head collapsing, (C) multyple crilling and ingection of Autogenous marrow blood. (E) RAO containment of head & full coverage of Acetabulum. (F) After regeneration of F head. expecting fill up the remaining space by top osteoohyte from femoral head.

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  Fig. 22 The postero medial capital drop is utilized to weight bearing head surfece (paradigm shift).

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  Fig. 23 Valgus flexion Osteotomy. In Tokyo Seminar/March 16, 2004; Kitasato University Hospital. (A) Pre op. 52F, (B) 1yr, (C) 18yrs.

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  Fig. 24 (A) Preop. Hip Score-52 Roof Osteophyte, (B) 6mos. 45-o; HS=90, (C) 19yrs. HS=92.

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  Fig. 25 The arrows are points incredible potentiality of reparative process. (A) 64 F. 1977, (B) 4yrs, (C) 11yrs, (D) 14yrs.

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  Fig. 26 48y-o. Female: AHI=55% (A) Preop, (B) 1yr, (C) 15yrs.

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  Fig. 27 In case of unsperical head, coapt the articular surpace in pararell by valgus osteotomy of proximal femur and RAO of acetabular socket.

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  Fig. 28 1. roof, 2. superior cervical, 3. capital drop, 4. Curtain, 5. inferior cervical, 6. floor osteophyte.

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