Periacetabular Osteotomy for Treatment of Acetabular Dysplasia through Iliofemoral approach

ABSTRACT

PURPOSE: To evaluate the clinical and radiologic results of periacetabular osteotomy, for treating acetabular dysplasia through iliofemoral approach. MATERIALS AND METHODS: We evaluated the results of 17 periacetabular osteotomies performed in 17 patients (12 female, 4 male). The osteotomies were performed through an iliofemoral approach in 17 hips. The mean age of the patients at the time of surgery was 34.7 years (range 14~61 years). The average follow-up period was 26 months (range 12~48 months). The D'Aubigine and Postel score was used for clinical evaluation. Radiological changes of acetabular head index, the CE angle (lateral and anterior), and the sharp angle were measured, respectively. RESULTS: Clinically, the mean D'Aubigine and Postel scores improved from 12.7 preoperatively to 15.1 postoperatively. All four radiological measurements improved significantly after surgery (Wilcoxon Rank Sum test p< 0.05). The following complications were noted posterior column fracture in 2 hips and peripheral nerve dysfunction was noted in 5 patients. Of these nerve palsy, lateral femoral cutaneous nerve palsy in 3 patients, 1 patient complained troublesome, transient sciatic nerve palsy and femoral nerve palsy in 1 patient. There were no vascular complications or heterotopic bone formation and conversion to total hip arthroplasty. CONCLUSION: Periacetabular osteotomy by the iliofemoral approach is an effective surgical treatment for acetabular dysplasia in adults, but should be careful nerve injuries.