Surgical Techniques of Eccentric Rotational Acetabular Osteotomy.

Abstract

This report describes the operative indications and essential techniques of eccentric rotational acetabular osteotomy for hip dysplasia in patients with either pre-osteoarthritis, early arthritis, or in some cases even advanced osteoarthritis of the hip. An accurate lateral decubitus position of the pelvis is important. Make a bikini skin incision and elevate the skin flap. Make a Y-shaped incision, retract the innominate fossa, and detach the greater trochanter with an oscillating saw. Partially release and divide the rectus femoris, detach the iliacus, and retract the iliopsoas. It is essential to use an osteotomy guide to perform an accurate spherical osteotomy. The osteotomy of the pubic bone is technically demanding. The acetabular fragment can be rotated to the intended position as determined by the preoperative planning. Fix the greater trochanter with two AO cancellous screws. Walking with a walker and partial weight-bearing begins one day after surgery, and full weight-bearing starts at two months postoperatively. The clinical and radiographic outcomes in the first 126 consecutive patients (132 hips) who had undergone eccentric rotational acetabular osteotomy at our institution were retrospectively assessed.IndicationsContraindicationsPitfalls & Challenges.