Background: Eccentric rotational acetabular
osteotomy for the operative treatment of acetabular dysplasia consists
of a spherical but eccentric osteotomy and rotation of the acetabulum
that moves the center of rotation of the head of the femur medially and
distally. No bone graft is needed. The reorientation of the acetabular
fragment not only improves acetabular coverage but also restores
the center of rotation of the subluxated hip. The purpose of this
paper was to describe eccentric rotational acetabular osteotomy
for the treatment of acetabular dysplasia and to evaluate its clinical
and radiographic outcomes.
Methods: We performed this procedure consecutively
in 132 hips in 126 patients with dysplasia of the hip. Eighteen
hips had no osteoarthritis, fifty-three had early osteoarthritis,
and sixty-one had advanced osteoarthritis. Seven patients were male, and
119 were female. The average age was 36.5 years at the time of the
index operation, and the average duration of follow-up was 7.5 years.
Twenty-three hips in twenty-two patients were also treated with
intertrochanteric valgus osteotomy to further improve joint congruency
at the time of the acetabular osteotomy.
Results: The average preoperative Harris hip score
of 71 points improved to an average score of 89 points at the time
of the latest follow-up. The average center-edge angle improved from
0Â° to 36Â°. An apparent change in the stage of the arthritis was
observed in seven hips (5%), one of which had had early-stage
disease and six of which had had advanced disease preoperatively.
Conclusions: Eccentric rotational acetabular osteotomy
appears to be a good treatment option for young patients with either
early or advanced hip osteoarthritis secondary to dysplasia.