Ganz Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip: Initial Experience and Results From the First 44 Cases

  • Gerardo Zanotti Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0001-8090-4832
  • Carlos Martín Lucero Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-1325-7027
  • Fernando Díaz Dilernia Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-7830-2207
  • Pablo Slullitel Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-8957-075X
  • Fernando Comba Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-2848-2983
  • Francisco Piccaluga Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0002-9887-4886
  • Martín Buttaro Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina https://orcid.org/0000-0003-3329-778X
DOI: https://doi.org/10.15417/issn.1852-7434.2021.86.6.1286
Keywords: Dysplasia, hip, osteoarthrosis, labrum, osteotomy, Ganz

Abstract

Objective: To describe the surgical technique, indications, and initial results of the Bernese periacetabular osteotomy (PAO) for the treatment of developmental dysplasia of the hip. Materials and Methods: Between May 2011 and May 2020, 44 PAOs were performed in 44 patients (35 women) with an average age of 30 years (23-38). All patients had a diagnosis of symptomatic hip dysplasia. The average center-edge angle was 17 (9 to 20) and the average acetabular index was 18 (15 to 20). In 22 cases, the intra-articular findings were evaluated and repaired by arthroscopy in the same surgical stage. The correction obtained, the consolidation of the osteotomy, and the functional outcomes at the end of the follow-up were evaluated. Results: Hypertrophy and rupture of the acetabular labrum associated with hip dysplasia were evidenced in 22 patients. Paralabral cysts were found in 10 patients in the series. The average postoperative center-edge angle was 32º (27º to 35º) and the acetabular index was 6º (4º to 9º). The surgical time for PAO was 130 minutes; in patients where an arthroscopic procedure was added, the time was 148 minutes. Conclusions: PAO is technically demanding, but has predictable outcomes in patients with articular cartilage integrity and correctable deformities. Arthroscopy before osteotomy allows assessing cartilage conditions, diagnosing and treating intra-articular lesions associated with this pathology, and deciding on the need to correct the soft tissue deficit.

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Author Biographies

Gerardo Zanotti, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Carlos Martín Lucero, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Fernando Díaz Dilernia, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Pablo Slullitel, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Fernando Comba, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Francisco Piccaluga, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Martín Buttaro, Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina
Hip Center “Sir John Charnley”, Orthopedics and Traumatology Institute “Carlos E. Ottolenghi”, Hospital Italiano de Buenos Aires, Autonomous City of Buenos Aires, Argentina

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Published
2021-12-16
How to Cite
Zanotti, G., Lucero, C. M., Díaz Dilernia, F., Slullitel, P., Comba, F., Piccaluga, F., & Buttaro, M. (2021). Ganz Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip: Initial Experience and Results From the First 44 Cases. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 86(6), 727-736. https://doi.org/10.15417/issn.1852-7434.2021.86.6.1286
Issue
Vol 86 No 6 (2021)
Section
Clinical Research
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