RESEARCH ARTICLE


A Modification of Periacetabular Osteotomy Using a Two-Incision Approach



Peter Bernstein*, Falk Thielemann, Klaus-Peter Günther
Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus Dresden, Medical Faculty of the Technical University Dresden, Fetscherstr. 74, D-01307 Dresden, Germany


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Creative Commons License
2007 Bentham Science Publishers Ltd

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.5/) which permits unrestrictive use, distribution, and reproduction in any medium, provided the original work is properly cited.

* Address correspondence to this author at the Department of Orthopaedic Surgery, University Hospital Carl Gustav Carus Dresden, Medical Faculty of the Technical University Dresden, Fetscherstr. 74, D-01307 Dresden, Germany; E-mail: peter.bernstein@uniklinikum-dresden.de


Abstract

In residual hip dysplasia periacetabular osteotomy (PAO) can improve insufficient coverage of the femoral head. It requires a broad dissection of the pelvic bones and detachment of muscle insertions, however. We have developed a modification of the Bernese periacetabular osteotomy with reduced soft tissue exposure. It uses two small skin incisions and offers therefore the perspective of nicer scars but also increases the risk of technical complications due to impaired vision. To be able to draft these risks, the clinical and radiographic results of 23 patients with PAO through the modified Smith-Petersen approach of Ganz (group A) and 24 patients with our two-incision modification (group B) have been reviewed retrospectively with an average follow-up of 19 (group A) and 12 (group B) months postoperatively.

Functional improvement (Harris Hip Score) and center-edge-angle normalization did not differ significantly in both groups. Scars of patients in group B were significantly shorter. However, the overall patient satisfaction (as measured with a visual analogous scale) was the same in both groups. 4 patients in group A and one patient in group B developed superficial or deep wound infections.

In conclusion, the experience with our cohort study showed that approach-related morbidity can be reduced without increasing the risk for the individual patient. This observation clearly holds a promise for further minimal invasive approaches as well as for further morbidity reduction of PAO.

Level of Evidence: Retrospective comparative study (Level III).