San Diego Acetabuloplasty

Neuromuscular hip dysplasia often results in posterior and lateral acetabular insufficiency. Many pelvic osteotomies have been used for its treatment. The San Diego acetabuloplasty is a clearly described procedure that results in predictable improvements in posterior and lateral acetabular coverage. Good clinical and radiographic results are reported when combined with single-stage hip reconstruction for patients with cerebral palsy. Herein, the technical details of the procedure are highlighted with a representative case and accompanying technique video.

(1)The San Diego acetabuloplasty aims to increase posterior and lateral acetabular coverage of the femoral head by maintaining an intact anterior-medial hinge point at the horizontal limb of the triradiate cartilage.(2)Outer-table dissection of the ilium is all that is required to perform the osteotomy in isolation, with limited bicortical violation only at the interspinous (between anterior superior and anterior inferior iliac spines) and sciatic notch regions.(3)Positive results have been reported with single-stage combination with femoral osteotomy for neuromuscular hip reconstruction in nonambulant patients.(4)An accompanying surgical technique video outlines the main technical considerations.