Periacetabular osteotomy is a surgery performed for patients with hip dysplasia. Hip dysplasia is a developmental malformation of the hip socket (acetabulum). The socket develops very shallow, inadequately covering the femoral head. The shallow hip socket leads to cartilage damage and subsequent arthritis.
Most patients go through childhood and early adulthood without any knowledge that their hip is abnormal. Usually by age 30, patients develop hip pain and x-rays taken by their physicians show the abnormal hip socket. Patients with severely dysplastic hips may be seen and treated as children by orthopaedic surgeons. Severe cases of hip dysplasia have an abnormal femur as well as acetabulum.
If hip dysplasia is left untreated, the hip will develop severe arthritis, often treated with hip replacement surgery. Unfortunately, patients with hip dysplasia develop severe arthritis at a very young age when it is less ideal to have a hip replacement. It is therefore ideal for patients with hip dysplasia to be seen when symptoms start, before severe arthritis develops. This is the ideal time for periacetabular osteotomy to be an effective surgery to preserve the hip joint.
Periacetabular osteotomy is a relatively new procedure to preserve the dysplastic hip. Dr. Reinhold Ganz in Bern, Switzerland developed the procedure with the help of an American surgeon, Dr. Jeffrey Mast in 1984. Dr. Joel Matta in Los Angeles learned of the procedure from his personal connections with Professor Ganz and Dr. Mast and visited Bern to learn the procedure himself in 1987. Dr. Matta has been performing the procedure for almost 20 years and has taught it to a handful of orthopaedic surgeons who are accepted to spend one year fellowships with him. This is where Dr. Yerasimides learned to perform the procedure and care for patients with hip dysplasia.
The procedure itself involves cutting the pelvis around the acetabulum, completely detaching the hip socket from the pelvis. The hip socket is then rotated to a position that provides adequate coverage of the femoral head. Screws are then used to hold the hip socket in position to allow bone healing. Sometimes, the femur also requires osteotomy to correct abnormal anatomy. Repositioning the hip socket preserves the patients hip joint. The goal is to relieve pain, prevent advancing arthritis and therefore prevent hip replacement surgery.
