Acetabuloplasty in Closed Triradiate Cartilage
Hip displacement is a common pathology in neuromuscular conditions, and progressive displacement or dislocation is associated with acetabular dysplasia, pain and decreased function and may lead to the need for hip salvage surgery. The Dega-type pelvic osteotomy is commonly used to correct acetabular dysplasia and maximize coverage of the femoral head in patients with open triradiate cartilages. In older patients, where the triradiate cartilage has closed, more complex peri-acetabular osteotomies are typically indicated. However, the Dega osteotomy can be a simple and effective technique to restore hip stability in patients with neuromuscular conditions, even after closure of the triradiate cartilage. While there are limited reports on the use of this technique in this manner, there are reports that suggest it can be effective in both ambulatory and non-ambulatory patients. In this particular case, the Dega osteotomy in combination with varus derotational osteotomy restored ambulation in a patient with closed triradiate cartilages who had stopped ambulating due to pain from hip displacement.
KeywordsAcetabuloplasty Dega osteotomy Cerebral palsy Varus derotational osteotomy Neuromuscular hip dysplasia Closed triradiate cartilage Reconstructive hip surgery Salvage hip surgery