Complete redirectional acetabular osteotomies for neurogenic and syndromic hip dysplasia.

Abstract

Neurogenic conditions and syndromes are often associated with clinically significant acetabular dysplasia and/or instability of the hip. Options for surgical treatment include reshaping, salvage, or redirectional pelvic osteotomies. "Complete" redirectional osteotomies, including the triple innominate osteotomy and the periacetabular osteotomy, completely free the acetabulum from the rest of the pelvis thereby allowing the surgeon to obtain large corrections and to control the position of the acetabulum in multiple planes. As a result, these procedures can be extremely useful in the treatment of certain neuromuscular conditions. In particular, complete redirectional osteotomies offer several specific advantages in the neurogenic and syndromic patient population: the procedures can be performed after skeletal maturity, they offer the surgeon the ability to correct acetabular version and the hypoplastic acetabulum, they allow hypercoverage when necessary and they may theoretically better preserve marginal ambulatory ability.