Berneese Periacetabular Osteotomy for Residual Hip Dysplasia in adults- a case report and review of literature

Pelvic osteotomy for acetabular dysplasia has been introduced to improve acetabular coverage of the femoral head and reduce the risk of secondary osteoarthrosis. Several surgical methods for acetabu-lar reorientation have been proposed for this purpose by reorientation of the acetabulum single, double,triple, spherical and periacetabular osteotomies.We report our first experience with peri-acetabulur berneese osteotomy described by Prof. R. Ganz and now the procedure of choice in appropriate-ly selected patients. Fifteen years old boy who pre-sented with complaints of fall and pain in the right gluteal region for 5 days duration that increased 233 J Pak Med Assoc with walking. Examination revealed an antalgic gait. Rest of his examination was normal except mild ten-derness in the right buttock area. His plain X-rays revealed an incidental finding of dysplastic left hip with deficient lateral coverage, deformed femoral head, coxa magna and mild coxa valga. In addition he had focal arthritic changes over the superolateral acetabulam with sclerosis and cyst formation. His anterior center-edge angle was 24 degrees with an acetabular index of 44 degrees. He had grade II arthritic changes according to the Tonnis classifica-tion of osteoarthritis. A periacetabulur ganz osteoto-my was performed.Correction was confirmed with intraoperative X-rays. His post operative course was smooth and he was allowed full weight bearing at 8 weeks when X-rays showed satisfactory healing of osteotomy