Femoral head decentration often persists after PAO for hip dysplasia

A retrospective analysis of 34 patients undergoing periacetabular osteotomy (PAO) for developmental dysplasia of the hip found that femoral head decentration, seen as a fluid gap on MRI, resolved completely in only 9 of 29 hips that had it preoperatively, despite reductions in decentration distance and radial extension overall. Hips with persistent decentration had higher preoperative femoral anteversion and acetabular index, and showed more severe cartilage damage, subchondral cysts, labral tears, and lower dGEMRIC index scores than hips in which decentration resolved. The authors state these findings suggest acetabular reorientation alone may be insufficient to fully restore joint containment in hips with excessive femoral anteversion or advanced intraarticular degeneration.

Most relevant for: Patients with developmental dysplasia of the hip being evaluated for or undergoing periacetabular osteotomy, particularly those with excessive femoral anteversion or preexisting intraarticular degeneration.

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