A comparison of different surgical approaches for the periacetabular osteotomy.

The periacetabular osteotomy is a well established surgical procedure for the preventative treatment of degenerative joint disease caused by symptomatic acetabular dysplasia. Surgeons on several continents use varying surgical approaches to achieve the same effective osteotomy. Individual surgical approaches must provide accurate and adequate exposure for the osteotomy and the reorientation of the acetabular fragment. The aim of the surgical approach for such complex and expansive surgery is to minimize morbidity related to the approach. This article compares experiences among three common approaches including the modified Smith-Petersen, ilioinguinal, and direct anterior approaches and describes the double approach.