1. Bernese Periacetabular Osteotomy for Hip Dysplasia - Salomi R. Vora

2. Progression of Hip Dysplasia1 Congenital/ acquired mal- alignment Reduced femoral coverage Increased contact stress at hip Degenerative joint disease Total hip Arthroplasty 3. Introduction The Bernese Periacetabular Osteotomy (BPO) was developed in 1984 and was published in 1988.2 This minimally invasive technique was developed to address the following needs; - Increased reorientation of acetabulum to increase hip contact area. - Increased stability of hemi- pelvis for immediate weight bearing in the post operative phase.1 4. Advantages of Osteotomy: Reorients acetabulum Increases load bearing area of hip. Reduces contact hip stress Prevents or delays progression of OA 5. Advantages of BPO:3 BPO Appropriate correction coverage while maintaining acetabular version. Single incision no damage of abductors No disruption of pelvic or outlet ring. Allows for capsulotomy to assess the labrum/ any impingement. 6. Criteria for performing BPO1,3: Young age (at least < 50- 55 years old) Presence of concentric / internal rotation hip motion. Spherical joint surfaces. No secondary arthrosis (Tonnis Grade 2/ less) 7. Functional Measures for Follow up1 WOMAC score Tonnis Classification for OA 8. Functional Outcome Study 1: - Population = 24 patients - Follow up duration = mean of 3.5 years - Results = 18 out of 24 patients showed high functional level on follow up.4 9. Study 2: - Population = 26 patients with unilateral osteotomies. - Follow up duration = 7-15 years. - Results = 4 patients THA, 8 patients considerable arthrosis and 14 patients no/ mild arthrosis on follow up. 1 10. Post Operative Therapy Recommendations1,3 Mobilization with partial weight bearing (20- 40 pounds)- 3 days. AROM Exercises with > 90 - 4 weeks Total weight bearing 6-8 weeks. 11. Resources WOMAC score: http://www.rheumatology.org/Practice/C linical/Clinicianresearchers/Outcomes_Inst rumentation/Western_Ontario_and_McM aster_Universities_Osteoarthritis_Index_(W OMAC)/ Tonnis classification for OA: http://www.preventivehip.org/hip- scores/tonnis-classification THANK YOU 12. References 1. Kralj M, Mavcic B, Antolic V, Iglic A, Kralj-Iglic V. The Bernese periacetabular osteotomy: clinical, radiographic and mechanical 7-15-year follow-up of 26 hips. Acta Orthopaedica. December 2005;76(6):833-840. 2. Ganz R, Klaue K, Vinh T, Mast J. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. 1988. Clinical Orthopaedics And Related Research. January 2004;(418):3-8. 3. Trousdale R, Cabanela M. Lessons learned after more than 250 periacetabular osteotomies. Acta Orthopaedica Scandinavica. April 2003;74(2):119. 1. Badra M, Anand A, Straight J, Sala D, Ruchelsman D, Feldman D. Functional outcome in adult patients following Bernese periacetabular osteotomy. Orthopedics. January 2008;31(1):69.