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Preoperative planning for redirective, periacetabular osteotomies

Albers, Christoph E. ; Rogers, Piet ; Wambeek, Nicholas ; Ahmad, Sufian S. ; Yates, Piers J. ; Prosser, Gareth H.

In: Journal of Hip Preservation Surgery, 2017, vol. 4, no. 4, p. 276-288

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    Titre
    • Preoperative planning for redirective, periacetabular osteotomies
    Auteur
    • Albers, Christoph E.. Department of Orthopaedic Surgery, Fremantle and Fiona Stanley Hospitals, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
    • Rogers, Piet. Department of Orthopaedic Surgery, Fremantle and Fiona Stanley Hospitals, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
    • Wambeek, Nicholas. Department of Radiology, Fremantle and Fiona Stanley Hospitals, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
    • Ahmad, Sufian S.. Department of Orthopaedic Surgery, University Hospital Bern, Freiburgstr. 4, 3010 Bern, Switzerland
    • Yates, Piers J.. Department of Orthopaedic Surgery, Fremantle and Fiona Stanley Hospitals, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
    • Prosser, Gareth H.. Department of Orthopaedic Surgery, Fremantle and Fiona Stanley Hospitals, 11 Robin Warren Dr, Murdoch, WA 6150, Australia
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Journal of Hip Preservation Surgery, 2017, vol. 4, no. 4, p. 276-288. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:332156
    Summary
    Redirective, periacetabular osteotomies (PAO) represent a group of surgical procedures for treatment of developmental dysplasia of the hip (DDH) in skeletally mature and immature patients. The ultimate goal of all procedures is to reduce symptoms, improve function and delay or prevent progression of osteoarthritis. During the last two decades, the understanding of the underlying pathomechanisms has continuously evolved. This is mainly attributable to the development of the femoroacetabular impingement concept that has increased the awareness of the underlying three-dimensional complexity associated with DDH. With increasing knowledge about the pathobiomechanics of dysplastic hips, diagnostic tools have improved allowing for sophisticated preoperative analyses of the morphological and pathobiomechanical features, and early recognition of degenerative changes, which may alter the long-term outcome. As redirective, PAO are technically demanding procedures, preoperative planning is crucial to avoid intraoperative obstacles and to sufficiently address the patient-specific deformity. Although conventional radiography has been used for decades, it has not lost its primary role in the diagnostic work-up of patients with DDH. Furthermore, an increasing number of modern imaging techniques exists allowing for assessment of early cartilage degeneration (biochemical magnetic resonance imaging) as well as 3D planning and computer-based virtual treatment simulation of PAO. This article reviews the literature with regard to the current concepts of imaging of DDH, preoperative planning and treatment recommendations for redirective, PAO.