Pelvic osteotomy: an alternative to total hip replacement in the young adult

For the young adult patient with a painful hip in whom there is acetabular dysplasia, innominate osteotomy is not only an alternative to total hip replacement, but rather it is the procedure of choice. If the prerequisites for a Steel or a Chiari osteotomy are met and if the procedures are adequately carried out, satisfactory relief of pain and return to function can be expected. The length of the satisfactory result is unknown as yet because an insufficient number of patients have been followed over a long enough period to determine the life expectancy of these procedures. It would appear, however, that it is going to be more than 10 years, which is certainly longer than one could expect for the current generation of cemented total joint replacements to last. Cementless total joint replacements are so new that a comparison cannot be made, but intuitively, a procedure that can leave the patient with his own tissue is the procedure of choice. Certainly, in a well-executed Steel or Chiari osteotomy, later reconstruction or total joint replacement will not be compromised.