ROTATIONAL PERIACETABULAR OSTEOTOMY WITH CONCURRENT HIP ARTHROSCOPY FOR THE TREATMENT OF HIP DYSPLASIA

ROTATIONAL PERIACETABULAR OSTEOTOMY WITH CONCURRENT HIP ARTHROSCOPY FOR THE TREATMENT OF HIP DYSPLASIA
From Kyung Hee University Hospital, Seoul, Korea
J Bone Joint Surg [Br] 2011;93-B:732-737.
Reconstruction of the acetabulum by osteotomy is an established and effective technique in the treatment of acetabular dysplasia. However, dysplasia is often accompanied by intra-articular pathology such as tears of the labrum. In this study the authors set out to determine whether a concurrent hip arthroscopy with rotational periacetabular osteotomy could detect and treat the intra-articular pathology associated with dysplasia and thereby produce a better result. 43 consecutive hips treated by concurrent arthroscopy and acetabular osteotomy were assessed prospectively. Arthroscopic examination revealed lesions of the labrum in 38 hips. At a mean follow-up of 74 months (60 to 97) the mean Harris Hip Score improved from 72.4 to 94 (p<0.001), and all the radiological parameters improved likewise. The complications comprised penetration of the joint by the osteotome in one patient, fracture of the posterior column in a second patient and deep vein thrombosis in another patient. This combined surgical treatment gave good results in the medium term.
The authors maintain that hip arthroscopy combined with osteotomy of the acetabulum can provide good results in patients with symptomatic acetabular dysplasia, and that arthroscopic treatment of the intra-articular pathology may alter the progression of osteoarthritis.