Clin Orthop Surg.  2017 Jun;9(2):129-135. 10.4055/cios.2017.9.2.129.

Rotational Acetabular Osteotomy

• Yasunaga Y
• Fujii J
• Tanaka R
• Yasuhara S
• Yamasaki T
• Adachi N
• Ochi M

• KMID: 2412279
• DOI: http://doi.org/10.4055/cios.2017.9.2.129

Abstract

Hip dysplasia is the most common cause of secondary osteoarthritis (OA). To prevent the early onset of secondary OA, Nishio's transposition osteotomy, Steel's triple osteotomy, Eppright's dial osteotomy, Wagner's spherical acetabular osteotomy, Tagawa's rotational acetabular osteotomy (RAO), and Ganz' periacetabular osteotomy (PAO) have been proposed. PAO and RAO are now commonly used in surgical treatment of symptomatic acetabular dysplasia in Europe, North America, and Asia. The aim of this paper is to present the followings: the patient selection criteria for RAO; the surgical technique of RAO; the long-term outcome of RAO; and the future perspectives.

Keyword

Hip dysplasia; Pelvic osteotomy

MeSH Terms

Acetabulum/*surgery
Adult
Hip Dislocation/*surgery
Humans
Middle Aged
Osteotomy/adverse effects/*methods
Rotation
Treatment Outcome

Figure

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  Fig. 1 Preoperative and postoperative radiographs. Preoperative anteroposterior (AP) views in neutral position (A) and abducted position (B). (C) Postoperative AP view in neutral position.

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  Fig. 2 Postoperative joint congruency is classified into 4 grades: excellent (A), good (B), fair (C), and poor (D).

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  Fig. 3 Surgical technique. (A) Skin incision. (B) The skin flap is elevated in posterior direction. (C) The rectus femoris is cut. (D) The site for osteotomy of the pubic bone is exposed. (E) The osteotomy line of the posterior wall of the acetabulum. A needle has been inserted in the joint. (F) The outer cortical bone of the ilium is cut with an air drill. (G) The outer cortical bone of the posterior wall and ischium has been cut. (H) The osteotomy of the anterior part of the ilium is shown. (I) The osteotomy of the posterior wall and ischium is shown. (J) The acetabulum is rotated in anterolateral direction. (K) The acetabulum is fixed with two poly-L-lactic acid (PLLA) screws. Ant: anterior, Inf: inferior, Sup: superior.

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