Developmental Dysplasia of the Hip (DDH) is a condition where the hip joint doesn't form properly during early childhood. This can lead to hip instability, pain, and early onset of osteoarthritis if left untreated. Hip preservation surgery has emerged as a crucial intervention for DDH, aiming to delay or prevent the need for total hip replacement in children and young adults.
DDH occurs when the hip socket (acetabulum) is too shallow or misaligned, causing inadequate coverage of the femoral head. This can range from mild instability to complete dislocation of the hip. Early detection and treatment are vital, as interventions in infancy can often correct the problem non-surgically. However, for older children and young adults with persistent DDH, surgical intervention may be necessary.
Hip preservation surgery encompasses various techniques designed to improve hip joint biomechanics and delay the progression of osteoarthritis. These procedures aim to restore normal hip anatomy, alleviate pain, and improve function. One of the most effective and widely used techniques for treating DDH in adolescents and young adults is the periacetabular osteotomy (PAO).
Periacetabular Osteotomy is a game-changer in Hip Preservation
The PAO, also known as the Bernese osteotomy, is a complex procedure that involves cutting the pelvis around the acetabulum and repositioning it to provide better coverage of the femoral head. This technique, developed by Professor Reinhold Ganz in Bern, Switzerland, has revolutionised the treatment of hip dysplasia in skeletally mature patients.
Key benefits of PAO include:
1. Improved femoral head coverage
2. Enhanced joint stability
3. More even distribution of forces across the hip joint
4. Potential to delay or prevent the need for total hip replacement
The procedure is particularly effective for young adults with symptomatic DDH who have not yet developed significant osteoarthritis. By correcting the underlying structural abnormality, PAO can provide long-term relief and preserve native hip joint function.
Post-surgery, patients undergo a comprehensive rehabilitation programme to regain strength, flexibility, and function. While recovery can be challenging, many patients report significant improvements in pain and quality of life following successful PAO surgery.
It's worth noting that Max Mifsud has received international training in hip preservation surgery and periacetabular osteotomy from the world-renowned Inselspital in Bern, Switzerland – the very institution where this groundbreaking technique was developed. This specialised training equips M
r. Mifsud with the expertise to provide high-quality care for patients with DDH and other hip disorders requiring preservation surgery.
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