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Endoscopy-Assisted Periacetabular Osteotomy.

ABSTRACT: Minimizing soft tissue dissection and improving visualization of vital structures during periacetabular osteotomy (PAO) is of paramount importance to improve patient outcome and minimize complications. The endoscopy-assisted PAO was introduced to accomplish this objective. It involves an initial hip arthroscopy, for treatment of central compartment pathology, followed by a mini-open Bernese periacetabular osteotomy under fluoroscopic and endoscopic guidance, and completed by final dynamic hip arthroscopy to assess acetabular reorientation and fixation and to perform femoroplasty in relation to the new acetabular rim position, if needed. Endoscopy-assisted PAO is used to treat dysplasia or acetabular retroversion in a minimally invasive fashion.

SUBMITTER: Matsuda DK

PROVIDER: S-EPMC4912685 | biostudies-literature | 2016 Apr

REPOSITORIES: biostudies-literature

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Endoscopy-Assisted Periacetabular Osteotomy.

Matsuda Dean K DK Martin Hal D HD Parvizi Javad J

Arthroscopy techniques 20160321 2

Minimizing soft tissue dissection and improving visualization of vital structures during periacetabular osteotomy (PAO) is of paramount importance to improve patient outcome and minimize complications. The endoscopy-assisted PAO was introduced to accomplish this objective. It involves an initial hip arthroscopy, for treatment of central compartment pathology, followed by a mini-open Bernese periacetabular osteotomy under fluoroscopic and endoscopic guidance, and completed by final dynamic hip ar ...[more]

PMID: 27354947

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Endoscopy-assisted periacetabular osteotomy: a preliminary cadaveric study.

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Sports activity participation after curved periacetabular osteotomy for acetabular dysplasia.

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Technique for Intraoperative Neuromonitoring During Periacetabular Osteotomy After Concomitant Hip Arthroscopy.

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Efficiency and Accuracy of Bernese Periacetabular Osteotomy for Adult Hip Dysplasia.

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Mean 20-year followup of Bernese periacetabular osteotomy.

Project description:UNLABELLED: The goal of the Bernese periacetabular osteotomy is to correct the deficient acetabular coverage in hips with developmental dysplasia to prevent secondary osteoarthrosis. We determined the 20-year survivorship of symptomatic patients treated with this procedure, determined the clinical and radiographic outcomes of the surviving hips, and identified factors predicting poor outcome. We retrospectively evaluated the first 63 patients (75 hips) who underwent periacetabular osteotomy at the institution where this technique was developed. The mean age of the patients at surgery was 29 years (range, 13-56 years), and preoperatively 24% presented with advanced grades of osteoarthritis. Four patients (five hips) were lost to followup and one patient (two hips) died. The remaining 58 patients (68 hips) were followed for a minimum of 19 years (mean, 20.4 years; range, 19-23 years) and 41 hips (60%) were preserved at last followup. The overall mean Merle d'Aubigné and Postel score decreased in comparison to the 10-year value and was similar to the preoperative score. We observed no major changes in any of the radiographic parameters during the 20-year postoperative period except the osteoarthritis score. We identified six factors predicting poor outcome: age at surgery, preoperative Merle d'Aubigné and Postel score, positive anterior impingement test, limp, osteoarthrosis grade, and the postoperative extrusion index. Periacetabular osteotomy is an effective technique for treating symptomatic developmental dysplasia of the hip and can maintain the natural hip at least 19 years in selected patients. LEVEL OF EVIDENCE: Level III, prognostic study.

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Detailing postoperative pain and opioid utilization after periacetabular osteotomy with automated mobile messaging.

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| S-EPMC7742655 | biostudies-literature

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