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Saturday, October 9, 2010, 11:15-11:50Session B19: Hip MechanicsRotational Acetabular Osteotomy With Femoral Osteotomy in IncongruentHip - Midterm Result -*Yoon Je Cho - Kyung Hee University - Seoul, KoreaSang Joon Kwak - Kyung Hee University - Seoul, Republic of KoreaYoung Soo Chun - - ,Kee Hyung Rhyu - Center for Joint Disease, Kyung Hee University East-West Neo MedicalCenter - Seoul, KoreaSe Min Lee - Kyung Hee University - Seoul, KoreaMyung Chul Yoo - Kyung Hee University - Seoul, Korea*Email: yjcho@khmc.or.krPurpose: To evaluate the clinical and radiologic midterm results of rotational acetabularosteotomy (RAO) in incongruent hip joints.Material and Methods: A consecutive series of 15 hips in 14 patients who underwent RAO inincongruent hip joint were evaluated at an average follow-up of 52.3 months (range from 36 to101 months). The average age at operation was 27 years (range from 12 to 38 years) old. Thepreoperative diagnoses were developmental dysplasia in 4 hips, sequelae of Legg-Calvé-Perthesdisease in 8 hips, and multiple epiphyseal dysplasia in 3 hips. The RAO procedures werecombined with a femoral valgus oseotomy in 10 hips, advance osteotomy of greater trochanterin 4 hips, derotational osteotomy in 2 hips. Clinically, Harris hip score, range of motion, leglength discrepancy(LLD) and hip joint pain were evaluated. Radiological changes of anteriorand lateral center-edge(CE) angle, acetabular roof angle, acetabular head index(AHI), ratio ofbody weight moment arm to abductor moment arm, and a progression of osteoarthritis wereanalyzed.Results: The Harris hip score ha been improved from average from 67.5 points preoperativelyto 97.6 points postoperatively. There have been no significant changes in the range of motion.The anterior CE angle increased from an average of 9.0°(-19.7 18.6°) to 32.5°(22.6 39.1°),the lateral CE angle from 7.6°(-12.1 14.1)° to 31.7°(26.5 37.8°) and the AHI from61%(33 73%) to 86%(65 100%). The average ratio of body weight moment arm to abductormoment arm was changed 1.88 to 1.49. There was no case showing progression ofosteoarthritis. None of the patients experienced revision surgery.Conclusion: The conventional salvage operation, such as Chiari osteotomy, has beenrecommended in incongruent hip. However, if we can expect to have a congruency after RAOwith/without any femoral osteotomies, it would be a hopeful procedure for the incongruentjoints by enhancing acetabular coverage, taking joint surface with normal articular cartilage,increasing abductor moment arm with additional improvement in LLD.Key Words: Incongruent hip, Rotational acetabular osteotomy, Valgus osteotomy.file:///E|/ISTA2010-Abstracts.htm[12/7/2011 3:15:47 PM]