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Rationale of periacetabular osteotomy and background work
M Leunig1, K A Siebenrock, R Ganz
1Department of Orthopaedic Surgery, University of Berne, Inselspital, Berne, Switzerland.
Instructional Course Lectures
|May 25, 2001
Summary
The Bernese periacetabular osteotomy (PAO) is a joint-preserving hip surgery that corrects acetabular coverage and stabilizes the femoral head. This procedure preserves pelvic dimensions, potentially allowing for future vaginal delivery.
Area of Science:
- Orthopedic Surgery
- Hip Preservation Surgery
Background:
- Acetabular dysplasia requires surgical correction to prevent hip osteoarthritis.
- The Bernese periacetabular osteotomy (PAO) is a recognized joint-preserving technique for hip instability.
Purpose of the Study:
- To describe the Bernese periacetabular osteotomy (PAO) technique.
- To highlight the benefits of PAO in correcting acetabular coverage and hip joint stability.
- To emphasize the preservation of pelvic dimensions for potential future vaginal delivery.
Main Methods:
- The Bernese periacetabular osteotomy (PAO) involves a polygonal, juxta-articular osteotomy.
- The modified Smith-Petersen approach is utilized, allowing for anterior capsulotomy and joint inspection.
- Minimal internal fixation of the acetabular fragment enables early mobilization.
Main Results:
- The procedure effectively improves acetabular coverage and femoral head stability.
- It corrects acetabular fragment version and reduces mediolateral displacement.
- Joint inspection allows for assessment of rim lesions and impingement-free range of motion.
Conclusions:
- The Bernese periacetabular osteotomy (PAO) is a successful joint-preserving hip surgery.
- It achieves anatomical correction and functional improvement of the hip joint.
- Preservation of pelvic dimensions is a significant advantage for female patients.