Rotational acetabular osteotomy through an Ollier lateral U approach

Various methods of periacetabular osteotomy have been described. Since 1990, we have performed rotational acetabular osteotomy through an Ollier lateral U transtrochanteric approach without massive bone graft. This study investigated whether our technique could provide relief from symptoms, whether postoperative hip abductor weakness would be a critical complication, and whether appropriate acetabular coverage could be achieved. We followed in 101 patients (110 consecutive hips) with a mean age at surgery of 32.5 years and a minimum followup of 5 years (mean, 8.3 years; range, 5-16.2 years). Satisfactory results were found in 94 (85%) hips. A positive Trendelenburg sign was observed in eight (7%) hips at last followup. Appropriate postoperative coverage was provided with an average centeredge angle of 35 degrees. We found radiographic evidence of deterioration of osteoarthritic changes in 14 (13%) hips. Complications included deep infection (one patient); pulmonary embolism (one patient); osteonecrosis of the rotated acetabular fragment (two patients); and proximal displacement of the greater trochanter because of breakage of the polylevolactic acid screws (four patients). This procedure allows osseous cuts with good operative exposure and provides relief from symptoms in most painful dysplastic hips.