ANATOMIC BASES OF A NEW TECHNIQUE OF JUXTA-ACETABULAR OSTEOTOMY - TECHNICAL PRINCIPLES AND PERFORMANCE

Pelvic osteotomies were developed to increase or restructure the aceta bular surface. Periacetabular osteotomies are considered the most diff icult from the technical point of view and necessitate sufficient resi dual cartilaginous surface. Juxta-acetabular osteotomies avoid major d isorganization of the pelvic framework and allow easier reorientation of the acetabulum. The authors present a technical variant that preser ves the entire posterior column, as in the Ganz osteotomy. The effects on the vascularisation of the periacetabular region are strictly the same and there is no necrosis of the subchondral bone. This osteotomy is easier to perform, because of a single positioning associating two simultaneous approaches. The osteotomies are rectilinear and easy to c heck peroperatively by fluoroscopy thanks to this positioning. Another valuable aspect of this double approach consists of very easy correct ion of ''automatic'' unwanted retroversion due to the lowering of the acetabular roof. This unintended displacement is rarely reported in th e literature, despite its anatomic evidence in 3-dimensional CT-scan r econstructions for pre- and peroperative evaluation.