B. J. A. Lankester and M. F. Gargan,
Trauma and Orthopaedics, Bristol Royal Infirmary, Bristol BS2 8HW, UK
Hip dysplasia is the most common cause of hip pain in young adults and is the most common cause of degeneration leading to total hip arthroplasty. The structural abnormality leads to increased force through a reduced weightbearing area, progressive breakdown of articular cartilage and secondary osteoarthritic change. The diagnosis of dysplasia is made on plain radiographs which demonstrate the extent of acetabular and femoral abnormality.
Conservative treatment often fails and symptoms may progress. There is a renewed interest in pelvic and femoral osteotomy in an attempt to restore the normal anatomical relationship to arrest or reverse the degenerative changes. Most often this involves a re-directional osteotomy of the acetabulum. Many techniques have been developed and the Bernese peri-acetabular osteotomy is described in detail in this article. Femoral osteotomy may be required if the primary structural abnormality is in the proximal femur, or if inadequate cover remains following acetabular surgery.
Current Orthopaedics. Volume 18, Issue 4 , August 2004, Pages 262-272.