The Journal of Bone and Joint Surgery 83:438 (2001)
© 2001 The Journal of Bone and Joint Surgery, Inc.
Instructional Course Lecture |
Rationale of Periacetabular Osteotomy and Background Work
Michael Leunig, MD,
Klaus A. Siebenrock, MD and
Reinhold Ganz, MD
An Instructional Course Lecture, American Academy of Orthopaedic
Surgeons
Michael Leunig, MD
Klaus A. Siebenrock, MD
Reinhold Ganz, MD
Department of Orthopaedic Surgery, University of Bern, Inselspital,
CH-3010 Bern, Switzerland. E-mail address for M. Leunig: michael.leunig@ insel.ch.
E-mail address for K.A. Siebenrock: klaus.siebenrock@insel.ch.
E-mail address for R. Ganz: reinhold.ganz@insel.ch
Printed with permission of the American Academy of Orthopaedic
Surgeons. This article, as well as other lectures presented at the
Academy’s Annual Meeting, will be available in March 2001
in Instructional Course Lectures, Volume 50. The complete volume
can be ordered online at www.aaos.org, or by calling 800-626-6726
(8 a.m.-5 p.m., Central time).
No benefits in any form have been received or will be received from
a commercial party related directly or indirectly to the subject
of this article. No funds were received in support of this study.
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Introduction
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Osteoarthrosis of the hip is frequently caused by mechanical abnormalities — for
example, residual deformity from developmental hip disease such
as acetabular dysplasia1. Untreated
acetabular dysplasia is the most common cause of secondary osteoarthrosis2,3 arising from pathological joint-loading
forces4. It has been reported
to cause secondary osteoarthrosis by the age of fifty years in 25
to 50 percent of patients5,6.
In order to improve the prognosis for the hip in this relatively young
cohort of patients, pelvic osteotomies have recently been introduced
to improve the abnormal anatomical conditions and reduce the load
across the hip joint7.
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Pathomechanisms
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In acetabular dysplasia, intrinsically normal intra-articular
soft-tissue structures are exposed to loading forces that physically exceed
their tolerance level, resulting in anatomical deformities and damage
to the hip joint. For example, deficient acetabular coverage of
the femoral head has been related to osteoarthrosis8,9, whereas the orientation of the femoral
. . . [Full Text of this Article]
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