Child and Young Adult Hip Preservation Program Surgical Treatment Options

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Surgical Treatment Options for Acetabular Dysplasia

Non-Surgical Treatment

Includes physical therapy (to strengthen muscles), activity restriction, weight loss, and/or pain medication.

Surgical Treatment

If an abnormality of the acetabulum is causing hip symptoms and leading the hip to wear out, and if surgery can correct the abnormality, then surgery should be considered. Since the wearing out of cartilage inside the hip joint becomes permanent, it is important to carefully discuss the appropriate timing of corrective surgery with your physician.

Surgical Options

Arthroscopy— An arthroscopy is a noninvasive technique for treating secondary problems inside the hip. An arthroscopy alone cannot correct the main problem of the abnormal orientation of the acetabular rim in dysplasia. Realignment operations such as the periacetabular osteotomy (PAO) can correct the important rim tilt problem.

Arthrotomy— An arthrotomy is a procedure in which the capsule surrounding the hip joint is opened to examine the articular cartilage. This type of procedure can fix some minor problems of the acetabular labrum and joint cartilage.

Femoral Realignment Osteotomy - For some severe deformities, the femur is cut and realigned into proper alignment.

Periacetabular osteotomy— A periacetabular osteotomy or PAO is considered to be the preferred surgical correction of acetabular dysplasia. This procedure preserves and improves the function of the patient's own hip joint rather than replacing it with an artificial one. The goal of the PAO is to reduce or eliminate pain, restore function, and maximize the functional life of the dysplastic hip.

A PAO involves rotating the shallow dysplastic acetabulum by cutting it free enough from its attachments within the pelvis so that it can be repositioned into a more stable alignment on the top of the head of the femur. In this new alignment, excessive pressure from the femoral head is more evenly distributed away from the sensitive rim area.

Treatment options for:

Acetabular labral tears
Developmental dysplasia of the hip (DDH)
Femoral anteversion
Hip dysplasia in the adolescent and young adult
Hip fracture
Hip impingement
Legg-Calve-Perthes disease
Slipped capital femoral epiphysis (SCFE)

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Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944