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Periacetabular Osteotomy

Periacetabular Osteotomy Hip anatomy. More video? Please visit https://dentalapplica.com/ The hip joint is a ball and a socket joint where the ball shaped head of the femur articulates with the acetabulum of the pelvic bone. The edge of the socket is lined with cartilage to form a rim around it called the labrum. The labrum deepens the socket providing more stability to the joint. The articulating surfaces of both the head of the femur and the acetabulum are covered with cartilage. Cartilage is a tough but flexible tissue that allows two bones to move over each other smoothly without friction. Hip dysplasia is a congenital hip condition where patients have either a shallow acetabulum (Acetabular dysplasia) or an abnormality in the shape of the upper portion of the femur. This causes symptoms of limping, waddling or walking on their toe. Hip Dysplasia progressively leads to premature degeneration of the cartilage of the hip joint and may cause a rim fracture or labral tear. Patients usually start experiencing pain in the groin region at 20 to 30 years of age. Periacetabular osteotomy is a surgical procedure to treat a congenital hip condition called hip dysplasia. This involves cutting the acetabulum from the pelvic bone and repositioning it with screws to allow for a better fit of the femoral head. The procedure reduces pain, restores function and prevents further deterioration of the hip joint, thereby increasing the life of the hip joint and postponing total hip replacement. The surgery can be done for children over 10 years of age and adults, preferably less than 40 years of age. Diagnosis. Based on the patient’s medical history, symptoms and physical examination, the doctor may suspect hip dysplasia. The diagnosis is confirmed by an X-ray of the hip joint. An MRI scan may be ordered to check the condition of the labrum. Initial treatment is aimed at managing the symptoms of pain and inflammation. Hip Dysplasia can only be treated surgically by either periacetabular osteotomy or total hip replacement. If left untreated it leads to progressive arthritis with increasing pain and progressive loss of hip function. Surgical Procedure. Periacetabular osteotomy is a technically challenging surgery and is therefore done under Fluoroscopy to provide the surgeon with continuous live X-ray guidance. The procedure is performed under general anesthesia with the patient lying on their back. An incision is made over the hip joint. The acetabulum is cut completely from the rest of pelvis using a surgical saw. The fragment of the bone containing the acetabulum is then rotated to a new position so that it covers the head of the femur more naturally. It is then fixed in the new position by inserting screws into the bone. Sometimes cutting and repositioning of the femoral head may be needed but is not known until during the operation. If necessary, this procedure, called a femoral osteotomy, will be done at the same time but does require another separate incision. The incision is closed with sutures and surgical staples.