Periacetabular osteotomy of the hip: the ilioinguinal approach.
Developmental hip dysplasia (DDH) is characterized by an anomalous growth of the hipjoint. Without adequate treatment, the natural history of DDH is development of secondary osteoarthritis in adulthood. The correction of the deformities modifies the biomechanics of the hip, which is important in order to slow down the progression of osteoarthritis and maybe to prevent and postpone this development. The Bernese periacetabular osteotomy is a procedure which reorientates the acetabular articular surface. Several surgical approaches have been used to achieve the same effective osteotomy. No surgical approach represents "the optimum", with selection of appropriate exposure representing a balance of advantages and disadvantages. We used the ilioinguinal approach in 32 periacetabular osteotomies for acetabular dysplasia performed between 1996 and 2002. The operation was successful in 30 patients with acceptable operation time and blood loss and few complications. The advantages and disadvantages with the ilioinguinal approach as compared to other possibile incisions are discussed.
Pogliacomi
Francesco
F
Institute of Clinical Orthopaedics and Traumatology, University of Parma, Parma Hospital, Parma, Italy. fpogliacomi@yahoo.com
Stark
Andrè
A
Vaienti
Enrico
E
Wallensten
Richard
R
D000077:Acetabulum; D000293:Adolescent; D000328:Adult; D001696:Biomechanical Phenomena; D016063:Blood Loss, Surgical; D001863:Bone Screws; D005267:Femoral Nerve / Q000293:injuries; D005500:Follow-Up Studies; D006617:Hip Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D006801:Humans; D007085:Ilium; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000517:prevention & control; D010027:Osteotomy / Q000379:methods*; D010342:Patient Acceptance of Health Care; D011183:Postoperative Complications; D011630:Pubic Bone / Q000601:surgery; D011859:Radiography; D012086:Reoperation; D016683:Supine Position; D016896:Treatment Outcome