BACKGROUND: Elimination of abnormally high joint-loading resulting in excessive contact stresses may prevent or reduce the onset of @entity571 in a @entity572 . A number of periacetabular osteotomies have been shown to be effective in restoring normal hip-joint mechanics. We treat @entity7195 with a periacetabular osteotomy performed through a modified Ollier transtrochanteric approach. In this report, we describe the operative technique and the clinical and radiographic results. METHODS: Thirty-six @entity1 (thirty-eight hips) in whom a painful @entity572 had been treated with a periacetabular osteotomy between March 1991 and June 1999 were included in the study. There were thirty-five female @entity1 and one male @entity1 with a mean age (and standard deviation) at the operation of 29.42 +/- 9.1 years. The technique utilizes a u-shaped skin incision, and a routine osteotomy of the greater trochanter with distal transfer if needed, and allows excellent visualization enabling the surgeon to perform the periacetabular osteotomy without penetrating the joint. RESULTS: At a mean of five years and six months postoperatively, the mean modified Harris hip score had improved from 59.1 +/- 15.8 points preoperatively to 87.97 +/- 14.3 points. Radiographically, the degree of @entity571 had decreased in eleven hips, remained unchanged in twenty-four, and worsened in three. The mean anterior center-edge angle had increased from 22.0 degrees +/- 12.9 degrees to 36.1 degrees +/- 12.3 degrees, the mean lateral center-edge angle had increased from -2.7 degrees +/- 14.4 degrees to 26.6 degrees +/- 14.1 degrees, the mean acetabular index angle had improved from 23.4 degrees +/- 6.6 degrees to 12.7 degrees +/- 4.6 degrees, and the mean acetabular head index had increased from 48.2% +/- 12.7% to 73.1% +/- 16.0%. The Shenton line was restored in eleven hips. Thirty @entity1 (thirty-two hips; 84%) had a satisfactory result. A poor preoperative functional score was associated with an unsatisfactory outcome (p = 0.00191). Complications included prolonged limping (eleven hips); numbness in the distribution of the lateral femoral cutaneous nerve (four); @entity2530 of the rotated acetabular fragment (two); and acetabulofemoral impingement, @entity2736 , and a defect on the rotated ilium (one hip each). CONCLUSIONS: Painful @entity572 should be treated before function becomes seriously impaired. We believe that periacetabular osteotomy through a modified @entity6446 , which allows osseous cuts to be made under direct vision, can be learned readily. It provides improved femoral head coverage and relief of symptoms in most painful @entity572 in adolescents and young adults.

Periacetabular osteotomy through a modified ollier transtrochanteric approach for treatment of painful XXXX .

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity571 :: ('MESH:D010003', 'Disease') :: ['osteoarthrosis'] @entity7195 :: ('OMIM:142700', 'Disease') :: ['acetabular dysplasia'] @entity572 :: ('MESH:D006617', 'Disease') :: ['dysplastic hips', 'dysplastic hip'] @entity2736 :: ('MESH:D009999', 'Disease') :: ['heterotopic ossification'] @entity6446 :: ('MESH:D004687', 'Disease') :: ['Ollier approach'] @entity2530 :: ('MESH:D010020', 'Disease') :: ['osteonecrosis']
@entity572 :: (MESH:D006617,Disease) :: ['dysplastic hips']
