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Direct Lateral Approach for Triple Pelvic Osteotomy.

Grigor Grigoryan1, Lucas Korcek, Mark Eidelman

  • 1From the Department of Orthopedic Surgery, Loma Linda University Medical Center, Loma Linda, CA (Dr. Grigoryan, Dr. Korcek, and Dr. Nelson); the Department of Orthopedic Surgery, Rambam Academic Hospital, Haifa, Israel (Dr. Eidelman); and the Paley Orthopedic and Spine institute At Saint Mary's Medical Center, West Palm Beach, FL (Dr. Paley).

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Triple pelvic osteotomy (TPO) using a direct lateral approach is as effective as the anterolateral approach for hip dysplasia treatment. This new TPO technique offers improved visualization and safety.

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Area of Science:

  • Orthopedic surgery
  • Hip preservation surgery

Background:

  • Triple pelvic osteotomy (TPO) is a surgical procedure to reorient the acetabulum.
  • It is indicated for developmental dysplasia of the hip, neuromuscular hip conditions, and Legg-Calvé-Perthes disease.

Purpose of the Study:

  • To compare radiographic outcomes of TPO using anterolateral and direct lateral approaches.
  • To describe a novel single-incision direct lateral approach for TPO.

Main Methods:

  • Retrospective cohort study of 22 patients undergoing TPO.
  • Comparison of patients who had TPO via anterolateral (n=10) versus direct lateral (n=12) approach.
  • Radiographic analysis of migration index and center-edge angle.

Main Results:

  • No significant difference in migration index or center-edge angle between the two TPO approaches.
  • The direct lateral approach provided direct visualization of the ischial osteotomy and safe sciatic nerve handling.

Conclusions:

  • The direct lateral approach for TPO yields equivalent radiographic outcomes to the anterolateral approach.
  • The direct lateral approach offers advantages in visualization and safety for TPO procedures.