Pelvic osteotomies in the treatment of acetabular dysplasia: Review

Abstract

Acetabular dysplasia of the hip in adolescent and adults is a primary cause of secondary arthritis of the hip. The most important reason is a decrease of weight bearing surface of acetabulum and excessive loading on osteocytes and chondrocytes of those surface beyond their capacities. Although total hip arthroplasty is an alternative modality in the treatment of acetabular dysplasia, this idea has some limitations in young patients. It's survival is almost 20-25 years and patients who had total hip prosthesis demanding more active life are the most important reasons for limitation in young age, though total hip replacement has excellent functional results. Therefore, biologic reconstructive. methods have attracted more attention in the particularly last 20 years in this context. Periacetabular and triple osteotomies as known-reorientation osteotomy-are the most frequently used as reconstructive methods. The aim of osteotomy is to provide coverage of the femoral head by a surface of hyaline cartilage, to expand and change the direction of weight-bearing surface and to reduce contact pressure on these areas. Subsequently, improvement in pain and function is observed. Furthermore, it is expected to prevent or delay of the onset of osteoarthrosis. However, it is very important to select a most executive indication for patients to obtain a satisfactory result in the management of acetabular dysplasia. Beside, a best method should be performed very well. In this study, it is mentioned about diagnosis, indication and most popular pelvic osteotomies for acetabular dysplasia in the light of literature and personal experience.