Safety and feasibility of the triple pelvic osteotomy combined with acetabuloplasty for adolescent neuromuscular hip dysplasia with a steep acetabulum: a novel modification: a technical note
Journal of pediatric orthopedics. Part B, vol.35, no.4, pp.373-377, 2026 (SCI-Expanded, Scopus)
- Publication Type: Article / Article
- Volume: 35 Issue: 4
- Publication Date: 2026
- Doi Number: 10.1097/bpb.0000000000001348
- Journal Name: Journal of pediatric orthopedics. Part B
- Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
- Page Numbers: pp.373-377
- Keywords: acetabuloplasty, adolescent hip dysplasia, Dega pelvic osteotomy, neuromuscular hip dysplasia, triple pelvic osteotomy
- Hacettepe University Affiliated: Yes
Abstract
Adolescent neuromuscular hip dysplasia involves abnormal acetabular morphology with insufficient coverage, femoral containment, and depth. The triple pelvic osteotomy (TPO) corrects acetabular orientation, while acetabuloplasty improves containment, but they are insufficient on their own for severe deformities where both coverage and depth are compromised; combining both procedures allows simultaneous correction of orientation and morphology. In this study, the feasibility and safety of this combined approach were evaluated in adolescents with steep acetabula and dysplasia. Between 2020 and 2023, patients with adolescent neuromuscular hip dysplasia underwent combined TPO-Dega acetabuloplasty. The radiographic outcomes included Sharp's angle, acetabular depth-width ratio, center-edge angle, migration index, and neck-shaft angle. The surgical time, blood loss, and complications were recorded. Five patients with cerebral palsy (mean age: 14.4, 11.5-16 years) underwent combined TPO-acetabuloplasty. The mean follow-up was 15.6 (12-24) months, mean surgical time was 294 (225-360) min, and mean blood loss was 469 (375-600) ml. Sharp's angle improved from 54° to 36° (51°-57° to 24°-42°), depth-width ratio from 0.12 to 0.24 (0.09-0.15 to 0.22-0.27), center-edge angle from -31.4° to 36.2° (-54.0° to 46.0°), and migration index from a mean of 83% (68-100%) to 0%, and neck- shaft angle from 165° to 125° (158°-170° to 121°-134°). No acetabular avascular necrosis or iliac nonunion was observed. Combined TPO-Dega acetabuloplasty appears to be a safe surgical option for adolescents with steep acetabula and dysplasia.