Chiari Pelvic Osteotomy

Abstract

The treatment of hip subluxation, whether from congenital disorders, neuromuscular problems, or acquired disease, remains a challenge. In particular, subluxation of the hip with secondary acetabular dysplasia is particularly difficult when the hip is irreducible and the triradiate cartilage is closed. Chiari in 1974 described a medial displacement osteotomy to be used in children and adults with hip dysplasia and poor joint congruency. Mid- to long-term results demonstrate that this osteotomy remains radiologically effective for at least 25 years. The Chiari osteotomy is an excellent salvage procedure for adolescent and young adults with limited osteoarthritis and hip subluxation and for children with spastic hip subluxation in the setting of closed triradiate cartilage, whose incongruity is not amenable to a re-directional osteotomy.