A New Minimally Invasive Transsartorial Approach for Periacetabular Osteotomy

Anders Troelsen, MD and Kjeld Soballe, MD, DMSc

Ganz et al. described a technique of periacetabular osteotomy in 1988. It is an extensive surgical procedure performed in young adults with acetabular dysplasia. The acetabulum is reoriented in order to optimize its coverage of the femoral head, thereby changing the pathological hip joint mechanics that can cause early osteoarthritis. The learning curve associated with this procedure is well documented, and technical and neurovascular complications have been reported by experienced surgeons. The occurrence of complications is greatly influenced by the experience of the surgeon and the choice of surgical approach. Several approaches for the Bernese periacetabular osteotomy are characterized by relatively extensive incisions and dissection and may require muscle detachment. The most commonly used approaches are the modified Smith-Petersen (iliofemoral) and the ilioinguinal approaches. A new, minimally invasive, transsartorial approach for the periacetabular osteotomy was developed by Professor Kjeld Søballe, MD, DMSc, Aarhus University Hospital. The primary aim of this approach was to minimize the tissue trauma during dissection. As a result, the duration of surgery, blood loss, transfusion requirements, and length of hospital stay may be minimized. However, it is necessary for this approach to be safe, and the rate of complications should be lower or comparable with that of currently accepted techniques. The reorientation of the acetabulum should not be compromised, since it is the cornerstone of the procedure. This submitted JBJS video supplement features the surgical technique.

Material Covered

• Approach
• Exposure
• Periacetabular Osteotomies
• Reorientation
• Surgical Pearls

Specifications

• Total Run Time: 26:12 minutes
• Catalog Number: 4075
• VJO Publication Date: June, 2009