LATERAL ACETABULAR OSTEOTOMY

The term ''lateral acetabular osteotomy'' means that unlike in Pembert on and Salter procedures osteotomy of the acetabular roof is directed from the lateral extracapsular rim in a medial direction. Controlled b y fluoroscopy, the surgeon should chisel bone to the most medial and p osterior part of the triradiate cartilage, but stop 3 mm before reachi ng it. After complete osteotomy is performed from the sciatic notch to the anteroinferior iliac spine, the acetabular roof can be turned dow n separately to a normal angle. Therefore, the joint obtains its norma l radius and stability immediately. Even extremely shallow acetabuli c an be treated successfully as long as the cartilage is not consolidate d. Follow-up investigations until the end of growth in 90 hip joints h ave shown that acetabular measurements were normal or slightly patholo gic in 82-93% of patients according to our grading system of normal va lues and degrees of deviation. When varus osteotomy was performed simu ltaneously, measurements of femoral neck and head were normal to sligh tly pathologic in only 47-50%. For this reason, we have avoided varus osteotomies in the last decade. No complications have occurred at the triradiate cartilage.