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Simultaneous periacetabular osteotomy and arthroscopically assisted treatment of  cam-related pathology in acetabular dysplasia

Published in N°012 - July / August 2021
Article viewed 36 times

Simultaneous periacetabular osteotomy and arthroscopically assisted treatment of cam-related pathology in acetabular dysplasia

By K.-P. Günther, J. Goronzy in category SURGICAL TECHNIQUE
University Center of Orthopaedics, Trauma and Plastic Surgery, University Medicine Carl Gustav Carus, TU Dresden, Germany / [email protected]

Acetabular dysplasia (AD) as well as femoroacetabular impingement (FAI) are frequent disorders and play an important role in the development of hip osteoarthritis (OA). The two entities can occur independent from each other, but also in combination. According to selected prevalence studies, the frequency of additional cam deformities in AD is between 10% and 80%.

Introduction

Acetabular dysplasia (AD) as well as femoroacetabular impingement (FAI) are frequent disorders and play an important role in the development of hip osteoarthritis (OA). The two entities can occur independent from each other, but also in combination (fig. 1).

Fig.1: Anteroposterior pelvic radiograph of a patient with acetabular dysplasia and femoral head asphericity (indicative of cam-FAI) with initial joint space narrowing on both sides

 

According to selected prevalence studies, the frequency of additional cam deformities in AD is between 10% and 80% (Table 1). Since the natural history of combined AD and FAI may even lead to earlier OA than AD alone (Wyles et al. 2017), it is important to treat both deformities appropriately.

Table 1: Frequency of associated cam-deformities in patients with acetabular dysplasia (AD) according to selected publications


Periacetabular osteotomy (PAO) as initially developed by (Ganz et al. 1988) has been shown in several long-term studies to be a successful operation for the treatment of AD, but the outcome depends on adequate correction of associated cam deformities (Albers et al. 2013; Beaule et al. 2015; Ziebarth et al. 2011). Although bump resection and head-neck recontouring can be performed though an arthrotomy either before or...

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