Treatment of malum coxae senilis, old slipped upper femoral, intrapelvic protrusion of the acetabulum, and coxa plana by means of acetabuloplasty. Mittelfristige ergebnisse der valgisierenden und medialisierenden intertrochanteren osteotomie mit verkurzung des coxalen femurendes bei der primaren protrusio acetabuli. Rosenmeyer B, Viernstein K, Schuhmann HJ. Protrusio acetabuli: diagnosis and treatment. McBride MT, Muldoon MP, Santore RF, Trousdale RT, Wenger DR. Protrusio acetabuli: its occurrence in the completely expressed Marfan syndrome and its musculoskeletal component and a procedure to arrest the course of protrusion in the growing pelvis. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. A stress analysis of acetabular reconstruction in protrusio acetabuli. Adolescent deformities of the acetabulum: an investigation into the nature of protrusio acetabuli. Breslau: Verlag Willibald August Holaufer 1816. ![]() Seltene Beobachtungen zur Anatomie, Physiologie und Pathologie gehorig, vol. Minimally invasive surgical methods such as hip arthroscopy are unable to cope with structural deformities and should be carefully considered. The amount of applied surgery needs to be well balanced with respect to age and symptoms of the patients, since the outcome will be largely determined by the preexisting OA of these hips. Concomitant procedures such as relative neck lengthening for trochanteric advancement and periacetabular and even intertrochanteric osteotomies might become necessary to normalize joint mechanics. Surgical treatment needs to be tailored according to the presented deformities and usually begins with a surgical hip dislocation to address pincer impingement including labral reconstruction. The most severe protrusion not only reveals global acetabular overcoverage (pincer impingement), but can occur with a high-riding trochanter and even a negatively tilted acetabular roof with medially shifting femoral head. In this technical report, the focus is on protrusion in the young adult after closure of the growth plate and in the absence of advanced OA. Individual treatment plans need to be based upon the entire clinical presentation including the appreciation of all skeletal deformities and the degree of OA. This chapter outlines an algorithmic approach to the surgical treatment of acetabular protrusion. Based on the complexity of deformities and the early occurrence of OA, acetabular protrusion remains even today a treatment challenge.
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