Acetabular dysplasia is a developmental disease that affects approximately 3-5% of the population and can cause hip pain in young adults.
What are the Causes of Acetabular Dysplasia?
•It appears in two ways.
•It may also be a result of unresolved childhood DDH.
•Approximately 3% incidence of residual hip dysplasia has been reported in adolescence following successful treatment of DDH.
•The development of adolescent-onset acetabular dysplasia is blamed on delayed ossification of the triradiate cartilage and inadequate development of the lateral secondary ossification centers at the acetabular rim, which ossify during adolescence, usually between 12 and 18 years of age.
•Abnormal hip anatomy causes abnormal hip mechanical behavior, which results in further anatomical abnormalities.
How to Diagnose Acetabular Dysplasia?
•In anamnesis; Slow-onset groin and lateral hip pain with or without minor trauma
•Increase in pain with sports, long-term walking or sitting
•In examination; There may be hip movement limitation and pain with movement.
•Since the reliability of clinical examination is low, conventional radiology is the main auxiliary diagnostic method.
•Therefore, in diagnosis;
•Direct radiographs; Coverage of the femoral head is reduced, the femoral neck is usually in a valgus and anteverted position, and is sometimes accompanied by subluxation of the hip.
•CT: It is especially helpful in evaluating the acetabulum and femoral neck angles and planning the surgery.
•MRI; In addition to other methods, it is important to evaluate the cartilage structure and labrum, as well as pathologies in the soft tissues around the hip.
•Intra-articular diagnostic injection can be used.
What is the Treatment of Acetabular Dysplasia?
•Various pelvic osteotomies have been recommended for the treatment of residual hip dysplasia in adolescents and young adults.
•Options include single, double and triple innominate osteotomies as well as periacetabular osteotomies.
•Bernese-Ganz PAO is a well-established treatment method for acetabular dysplasia with the ability to reorient the acetabulum in all three planes.
•Variation-valgization and rotational osteotomies can be added to these osteotomies for proximal femoral deformities.
•Goals of reconstructive osteotomies;
•Increasing the harmony between the pre-arthritic acetabulum or the femoral head and the hyaline articular cartilage by repositioning the femoral head to maximize its coverage,
•To delay or prevent the onset of secondary osteoarthritis by reducing the increased joint cartilage load.