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Acetabular Protrusion and Surgical Technique

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

Based on the complexity of deformities and the early occurrence of OA, acetabular protrusion remains even today a treatment challenge. This chapter outlines an algorithmic approach to the surgical treatment of acetabular protrusion. Individual treatment plans need to be based upon the entire clinical presentation including the appreciation of all skeletal deformities and the degree of OA. In this technical report, the focus is on protrusion in the young adult after closure of the growth plate and in the absence of advanced OA. The most severe protrusion not only reveals global acetabular overcoverage (pincer impingement), but can occur with a high-riding trochanter and even a negatively tilted acetabular roof with medially shifting femoral head. Surgical treatment needs to be tailored according to the presented deformities and usually begins with a surgical hip dislocation to address pincer impingement including labral reconstruction. Concomitant procedures such as relative neck lengthening for trochanteric advancement and periacetabular and even intertrochanteric osteotomies might become necessary to normalize joint mechanics. The amount of applied surgery needs to be well balanced with respect to age and symptoms of the patients, since the outcome will be largely determined by the preexisting OA of these hips. Minimally invasive surgical methods such as hip arthroscopy are unable to cope with structural deformities and should be carefully considered.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Schulthess Clinic, Zürich, Switzerland

    Michael Leunig

  2. Emeritus Inselspital Bern, Bern, Switzerland

    Reinhold Ganz

  3. Faculty of Medicine, University of Bern, Bern, Switzerland

    Reinhold Ganz

Authors
  1. Michael Leunig
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  2. Reinhold Ganz
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Corresponding author

Correspondence to Michael Leunig .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, IL, USA

    Shane J. Nho

  2. Department of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USA

    Bedi Asheesh

  3. Department of Orthopedic Surgery, Case Western Reserve University, Cleveland, OH, USA

    Michael J. Salata

  4. Department of Orthopedic Surgery, Duke Medical Center, Durham, NC, USA

    Richard C. Mather III

  5. Department of Orthopedic Surgery, Weill Medical College of Cornell Univers, New York, NY, USA

    Bryan T. Kelly

Section Editor information

  1. Hospital for Special Surgery, New York, USA

    Benedict U. Nwachukwu

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Leunig, M., Ganz, R. (2021). Acetabular Protrusion and Surgical Technique. In: Nho, S.J., Asheesh, B., Salata, M.J., Mather III, R.C., Kelly, B.T. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7321-3_51-2

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  • DOI: https://doi.org/10.1007/978-1-4614-7321-3_51-2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-7321-3

  • Online ISBN: 978-1-4614-7321-3

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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Chapter history

  1. Latest

    Acetabular Protrusion and Surgical Technique
    Published:
    20 March 2021

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_51-2

  2. Original

    Acetabular Protrusion and Surgical Technique
    Published:
    17 June 2014

    DOI: https://doi.org/10.1007/978-1-4614-7321-3_51-1

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