| Abstract [eng] |
Hip dysplasia is a congenital disorder of varying degrees of joint instability caused by structural deformities of the acetabulum and/or femoral head. Although the age of diagnosis varies widely, the condition is usually found during infancy due to routine screening recommendations. In adults, the main symptom is pain in the groin area which is often triggered by physical activity or prolonged sitting. Diagnosis of hip dysplasia in adults is based on pelvic radiographs and evaluation of specific radiological parameters. There are many parameters used to assess different characteristics of hip dysplasia, but the most common one Wiberg angle. Which indicates the lateral coverage of the femoral head by the acetabulum. Wiberg angle of ≤ 25° is diagnostic for dysplasia. If left undiagnosed, hip dysplasia leads to long-term joint instability, resulting in altered joint biomechanics and uneven distribution of mechanical stress, ultimately causing faster joint degeneration and development of osteoarthritis. The primary goal of treatment in adults is to reduce symptoms and restore normal joint biomechanics, thereby slowing the progression of osteoarthritis and delaying the need for total hip arthroplasty. One of the treatment options is the periacetabular osteotomy procedure, which involves reorienting the acetabulum to increase femoral head coverage. Unlike other types of osteotomies, this surgery preserves the posterior column of the pelvis, thus maintaining greater pelvic ring stability. Naturally, various complications may occur during this procedure, such as neurapraxia, nonunion or malunion at osteotomy sites, stress fractures, insufficient correction of the Wiberg angle, and others. According to the literature, this procedure delays the need for total hip replacement in 91 % of patients for at least 10 years. Physicians have only been performing periacetabular osteotomy surgery in Lithuania since 2021, and this surgery is currently available in only one hospital. Thus, it is not yet widely discussed or known. Therefore, the aim of this paper is to present a descriptive literature review on hip dysplasia‘s pathomorphology, diagnostic features, periacetabular osteotomy surgery, possible complications and outcomes, and to discuss clinical cases. Three clinical cases of hip dysplasia treated with PAO are analysed in this work. The cases illustrate varying diagnostic and treatment paths—from smooth and straightforward to complicated courses involving diagnostic challenges and treatment complications. Each case includes a brief anamnesis, clinical examination, radiological findings and measurements, treatment course, and any resulting complications. |
