Review Question - QID 7061

The patient has developmental dysplasia of the hip (DDH). There is anterolateral deficiency of the acetabulum as is evidenced by the increased acetabular index and the reduced center-edge angle. The patient has some arthritis of the hip with narrowing of the joint space and cyst formation visible on the radiograph. Although all of the mentioned choices may be acceptable treatments for dysplasia of the hip, periacetabular osteotomy is the best and most appropriate option for this young patient. Periacetabular osteotomy allows correction of the problem and can even improve the joint space as the new region of the acetabulum is rotated into the weight-bearing region. Hip fusion is very poorly tolerated by young patients, especially women. Femoral osteotomy alone is unlikely to address the problem because the major problem is on the acetabular side. Although the patient has arthritis, because of the young age of the patient, prosthetic replacement is not an attractive option. The outcome of periacetabular osteotomy even for patients with moderate arthritis has been favorable, deferring the need for total hip arthroplasty by a mean of 6.5 years.