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Surgical Technique: Eccentric Rotational Acetabular Osteotomy for Adult Hip Dysplasia

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

The aim of the eccentric rotational acetabular osteotomy (ERAO) is to correct the deficient acetabular coverage in the dysplastic hip in order to prevent, or delay, the development of secondary osteoarthritis. The primary indications for ERAO include pain lasting more than 6 months, adequate range of motion, radiographic evidence of residual hip dysplasia, and pre- or early osteoarthritis, which are identical to those of periacetabular osteotomy (PAO) or rotational acetabular osteotomy (RAO). Preoperative good or excellent congruence according to a maximum abduction hip radiogram is essential for ERAO. More meticulous re-orientation of the acetabular fragment is possible in ERAO than that of PAO. The clinical and radiographic outcomes in the first 126 consecutive patients (132 hips) who underwent ERAO at our institution were good or excellent. Thirty hips had a fair clinical outcome. The cumulative survivorship at 15 years and at the final follow-up at 23 years was 97% and 80%, respectively. ERAO is an effective surgical procedure for treating symptomatic hip dysplasia in the pre- and early stage and maintains excellent or good native hip function at a mean of 20-years after surgery.

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References

  1. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. Acta Chir Scand. 1939;(Suppl):5–58.

    Google Scholar 

  2. Cooperman DR, Wallensten R, Stulberg SD. Acetabular dysplasia in the adult. Clin Orthop Relat Res. 1983;175:79–85.

    Article  Google Scholar 

  3. Murphy SB, Ganz R, Muller ME. The prognosis in untreated dysplasia of the hips: a study of radiographic factors that predict the outcome. J Bone Joint Surg Am. 1995;77(7):343–50.

    Article  Google Scholar 

  4. Dorey F. Survivorship analysis of surgical treatment of the hip in young patients. Clin Orthop Relat Res. 2004;418:23–8.

    Article  Google Scholar 

  5. Eskelinen A, Remes V, Pulkkinen P, Nevalainen J, Paavolainen P. Uncemented total hip arthroplasty for primary osteoarthritis in young patients. A mid- to long-term follow-up study from Finnish Arthroplasty Resister. Acta Orthop Scand. 2006;77:57–70.

    Article  Google Scholar 

  6. Gracia-Rey E, Cruz-Pardos A, Gracia-Cimbreo E. Almina-on almina total hip arthroplasty in young patients. Diagnosis is more important than age. Clin Orthop Relat Res. 2009;467:2281–9.

    Article  Google Scholar 

  7. Halvorsen V, Fenstad AM, Engesæter LB, Nordsletten L, Overgaard S, Pedersen AB, Kärrholm J, Nohaddes M, Eskelnen A, Mäkelä K, Höhrl S. Outcome of 881 total hip arthroplasty in 747paatients 21 years or younger: data from Nordic Arthroplasty Register Association (NARA) 1995–2016. Acta Orthop. 2019;90(4):331–7.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Nishio A. Transposition osteotomy of acetabulum for the treatment of congenital dislocation of the hip. Nippon Seikeigeka Gakkai Zasshi. 1956;30:482–4.

    Google Scholar 

  9. Schramm M, Hohmann D, Radespiel-Troger M, Pitto RP. Treatment of the dysplastic acetabulum with Wagner spherical osteotomy. A study of patients followed for a minimum of twenty years. J Bone Joint Surg Am. 2003;85-A:808–14.

    Article  Google Scholar 

  10. Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;465:1633–44.

    Article  Google Scholar 

  11. Siebenrock KA, Scholl E, Lottenbach, Ganz R. Bernese periacetabular osteotomy. Clin Orthop Relat Res. 1999;363:9–20.

    Article  Google Scholar 

  12. Nakamura S, Ninomiya S, Takatori Y, Morimoto S, Umeyama T. Long-term outcome of rotational acetabular osteotomy. 145 hips followed for 10-23 years. Acta Orthop Scand. 1998;69:259–65.

    Article  CAS  PubMed  Google Scholar 

  13. Nozawa M, Shitoto K, Matsuda K, Maezawa K, Kurosawa H. Rotational acetabular osteotomy for acetabular dysplasia. A follow-up more than ten years. J Bone Joint Surg Br. 2002;84-B:59–65.

    Article  Google Scholar 

  14. Miller NH, Krishnan SG, Kamaric E, Noble PC. Long-term results of the dial osteotomy in the treatment of high-grade acetabular dysplasia. Clin Orthop Relat Res. 2005;433:115–23.

    Article  Google Scholar 

  15. Migaud H, Chantelot C, Giraud F, Fontine C. Long-term survivorship of hip shelf arthroplasty and Chiari osteotomy in adults. Clin Orthop Relat Res. 2004;418:81–6.

    Article  Google Scholar 

  16. Ninomiya S, Tagawa H. Rotational acetabular osteotomy for the dysplastic hip. J Bone Joint Surg Am. 1986;66-A:430–6.

    Google Scholar 

  17. Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias. Clin Orthop Relat Res. 1988;232:26–36.

    Article  Google Scholar 

  18. Trousdale RT, Ekkernkamp A, Ganz R, Wallrichs SL. Periacetabular and intertrochanteric valgus osteotomy for the treatment of osteoarthrosis in dysplastic hips. J Bone Joint Surg Am. 1995;77A:73–85.

    Article  Google Scholar 

  19. Hasegawa Y, Iwase T, Kitamura S, Kawasaki M, Yamaguchi J. Eccentric rotational acetabular osteotomy for acetabular dysplasia. Follow-up of one hundred and thirty-two hips for five to ten years. J Bone Joint Surg Am. 2002;84-A(3):407–10.

    Google Scholar 

  20. Jingushi S, Sugioka Y, Noguchi Y, Miura H, Iwamoto Y. Transtrochanteric valgus osteotomy for the treatment of osteoarthritis of the hip secondary to acetabular dysplasia. J Bone Joint Surg Br. 2002;84-B:535–9.

    Article  Google Scholar 

  21. Hasegawa Y, Iwase T, Kitamura S, Kawasaki M, Yamaguchi J. Eccentric rotational acetabular osteotomy for acetabular dysplasia and osteoarthritis: follow-up at mean duration of twenty years. J Bone Joint Surg Am. 2014;96(23):1975–82.

    Article  PubMed  Google Scholar 

  22. Morita D, Hasegawa Y, Seki T, Amano T, Takegami Y, Kasai T, Higuchi Y, Ishiguro N. A possible new radiographic predictor of progression of osteoarthritis in developmental dysplasia of the hip: the center gap. Clin Orthop Relat Res. 2018;476:2157–66.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fracture: treatment by mold arthroplasty. An end-result study using a new method of new result evaluation. J Bone Joint Surg Am. 1976;51-A:737–55.

    Google Scholar 

  24. Merle d’Aubigné R, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36-A:451–75.

    Article  Google Scholar 

  25. Heyman CH, Herndon CH. Legg-Perthes disease: a method for measurement of roentgenographic results. J Bone Joint Surg Am. 1950;32-A:767–8.

    Article  PubMed  Google Scholar 

  26. Hasegawa Y, Kanoh T, Seki T, Matsuoka A, Kawabe K. A joint space wider than 2 mm is essential for an eccentric rotational acetabular osteotomy. J Orthop Sci. 2010;15:620–5.

    Article  PubMed  Google Scholar 

  27. Yasunaga Y, Ochi M, Terayama H, Tanaka R, Yamasaki T, Ishii Y. Rotational acetabular osteotomy for advanced osteoarthritis secondary to dysplasia of the hip. J Bone Joint Surg Am. 2006;88-A:1915–9.

    Google Scholar 

  28. Rab GT. Lateral acetabular rotation improves anterior hip subluxation. Clin Orthop Relat Res. 2006;456:170–5.

    Article  Google Scholar 

  29. Genda E, Konishi N, Hasegawa Y, Miura T. A computer simulation study of normal and abnormal hip contact pressure. Arch Orthop Trauma Surg. 1995;114:202–6.

    Article  CAS  PubMed  Google Scholar 

  30. Shoji T, Yamasaki T, Izumi S, Sawa M, Akiyama Y, Yasunaga Y, Adachi N. Evaluation of articular cartilage following rotational acetabular osteotomy for hip dysplasia using T2 mapping MRI. Skeletal Radiol. 2018;47:1467–74.

    Article  PubMed  Google Scholar 

  31. Hasegawa Y. Surgical techniques of Eccentric rotational acetabular osteotomy. JBJS Essent Surg Tech. 2015 Sep 23;5(3):e18. https://doi.org/10.2106/JBJS.ST.N.00099. eCllection 2015 Sep 23.

  32. Irie T, Takahashi D, Asano T, Arai R, Konno T, Onodera T, Kondo, Iwasaki N. Comparison of femoral head translation following eccentric rotational acetabular osteotomy and rotational acetabular osteotomy. Int Orthop. 2017;27(1):49–54.

    Google Scholar 

  33. Yasunaga Y, Ochi M, Yamasaki T, Shoji T, Izumi S. Rotational acetabular osteotomy for pre- and early osteoarthritis secondary to dysplasia provides durable results at 20 years. Clin Orthop Relat Res. 2016;474(10):2145–53.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Yasunaga Y, Takahashi K, Ochi M, Ikuta Y, Hisatome T, Nakashiro J, Yamamoto S. Rotational acetabular osteotomy in patients forty-six years of age or older: Comparison with younger patients. J Bone J Surg (Am). 2003;85A:266–72.

    Article  Google Scholar 

  35. Yasunaga Y, Yamazaki T, Ochi M. Patients selection criteria for periacetabular osteotomy or rotational acetabular osteotomy. Clin Orthop Relat Res. 2012;470:3342–54.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Kaneuji A, Sugimori T, Ichiseki T, Fukui K, Takahashi E, Matsumoto T. Rotational acetabular osteotomy for osteoarthritis with acetabular dysplasia conversion rate to total hip arthroplasty within twenty years and osteoarthritis progression after a minimum of twenty years. J Bone Joint Surg Am. 2015;97(9):726–32.

    Article  PubMed  Google Scholar 

  37. Yamaguchi J, Hasegawa Y, Kanoh T, Seki T, Kawabe K. Similar survival of eccentric rotational acetabular osteotomy in patients younger and older than 50 years. Clin Orthop Relat Res. 2009;467:2630–7.

    Article  PubMed  PubMed Central  Google Scholar 

  38. Teratani T, Naito M, Kiyama T, Maeyama A. Periacetabular osteotomy in patients fifty years of age or older. J Bone J Surg (Am). 2010;92-A:31–41.

    Article  Google Scholar 

  39. Trousdale RT, Cabanela ME. Lessons learned after more than 250 periacetabular osteotomies. Acta Orthop Scand. 2003;74:119–26.

    Article  PubMed  Google Scholar 

  40. Clohisy JC, Schuz AL, John LS, Schoenecker PL, Wright RW. Periacetabular osteotomy. A systematic literature review. Clin Orthop Relat Res. 2009;467:2041–52.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Sambandam SN, Hull J, Jiranek WA. Factors predicting the failure of Bernese periacetabular osteotomy: a meta-regression analysis. Int Orthop. 2009;33:1483–8.

    Article  PubMed  Google Scholar 

  42. Clohisy JC, John LCS, Nunley RM, Schutz AL, Schoenecker PL. Combined periacetabular and femoral osteotomy for severe hip deformities. Clin Orthop Relat Res. 2009;467:2221–7.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Lee CB, Millis MB. Alternative to periacetabular osteotomy for adult acetabular dysplasia. Instr Course Lect. 2013;62:287–95.

    PubMed  Google Scholar 

  44. Amano T, Hasegawa Y, Seki T, Takegami Y, Murotani K, Ishiguro N. A pre-operative predictive score for the outcome of eccentric rotational acetabular osteotomy in the treatment of acetabular dysplasia of the hip in adults. Bone Joint J. 2016;98-B:1326–32.

    Article  CAS  PubMed  Google Scholar 

  45. Parvizi J, Burmeister H, Ganz R. Previous Bernese periacetabular osteotomy does not compromise the results of total hip arthroplasty. Clin Orthop Relat Res. 2004;423:118–22.

    Article  Google Scholar 

  46. Hartig-Andreasen C, Stilling M, Soballe K, Thillemann TM, Troelsen A. Is cup positioning challenged in hips previously treated with periacetabular osteotomy? J Arthroplasy. 2014;29:763–8.

    Article  Google Scholar 

  47. Osawa Y, Hasegawa Y, Seki T, Amano T, Higuch Y, Ishiguro N. Significantly poor outcomes of total hip arthroplasty after failed periacetabular osteotomy. J Arthroplasy. 2016;31:1904–9.

    Article  Google Scholar 

  48. Osawa Y, Hasegawa Y, Seki T. Long-term outcomes of eccentric rotational acetabular osteotomy combined with femoral osteotomy for hip dysplasia. J Arthroplasy. 2020;35:17–22.

    Article  Google Scholar 

  49. Imai H, Kamada T, Miyawaki J, Muraishi A, Mashima N, Miura H. Outcomes of computer-assisted peri-acetabular osteotomy compared with conventional osteotomy in hip dysplasia. Int Orthop. 2020;44:1055–61.

    Article  PubMed  Google Scholar 

  50. Enishi T, Yagi H, Higuchi T, Takeuchi M, Sato R, Yoshioka S, Nakamura M, Nakano S. Changes in muscle strength of the hip after rotational acetabular osteotomy. Bone joint J. 2019;101-B:1459–63.

    Article  PubMed  Google Scholar 

  51. Tuboi M, Hasegawa Y. Muscle strength recovery after eccentric rotational acetabular osteotomy unpublished data

    Google Scholar 

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Acknowledgment

Investigation performed at the Department of Orthopedics, Nagoya University Graduate School of Medicine, 466-8550, Nagoya City, Japan

Author information

Authors and Affiliations

  1. Department of Rehabilitation, Kansai University Welfare Sciences, Kashiwara, Japan

    Yukiharu Hasegawa

  2. Department of Orthopedic Surgery, Yoshida Orthopedic Hospital, Toyota, Japan

    Masaki Tsuboi

Authors
  1. Yukiharu Hasegawa
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  2. Masaki Tsuboi
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Corresponding author

Correspondence to Yukiharu Hasegawa .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Bedi Asheesh

  3. Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopedic Surgery, Duke Medical Center, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopedic Surgery, Weill Medical College of Cornell Univers, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, NY, USA

    Benedict U. Nwachukwu

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Hasegawa, Y., Tsuboi, M. (2022). Surgical Technique: Eccentric Rotational Acetabular Osteotomy for Adult Hip Dysplasia. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_171-1

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  • DOI: https://doi.org/10.1007/978-1-4614-7321-3_171-1

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  • Print ISBN: 978-1-4614-7321-3

  • Online ISBN: 978-1-4614-7321-3

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