Five Treatment Models of Dysplastic OA by the RAO

Chang Soo Kang

doi:10.5371/hp.2012.24.3.165

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Kang: Five Treatment Models of Dysplastic OA by the RAO

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Hip & Pelvis

Hip & Pelvis 2012; 24(3): 165-185.

Published online: 30 September 2012

DOI: https://doi.org/10.5371/hp.2012.24.3.165

Five Treatment Models of Dysplastic OA by the RAO

Chang Soo Kang, MD, PhD

Daegu Health College University Hospital, Daegu, Korea.

Address reprint request to Chang Soo Kang, MD, PhD. Daegu Health College University Hospital, 209, Dongcheon-dong, Buk-gu, Daegu 702-885, Korea. TEL: +82-53-423-3155, FAX: +82-53-423-3155, cskang@empal.com

Received 30 May 2012 Revised 3 August 2012 Accepted 13 August 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Figures and Tables

Fig. 1

Adapted from Ninomiya, Tagawa JBJS. 1984;65A:430-6.

Fig. 2

Drawings illustrating the grades of congruity of the hip joint (adapted from Bauer and Kerschbaumer). (A) Grade 1, (B) Grade 2, (C) Grade 3, (D) Grade 4.

Fig. 3

The resultant force acting on the hip joint in inpotal Monopodal stance phase.

Fig. 4

Fig. 5

(A) ROA: 30°, CEA: 0°, (B) lateralized acetabulum (thick medial wall, shallow acetabular socket), (C) Do not cut through the Kohlers line, (D) Post op figure.

Fig. 6

(A) CE: 8°, (B) CE: 45°, ROA: reversed, medial shift, (C) 39ys PO 21y.

Fig. 7

(A) Pre op bilateral dysplatic hip, (B) Post op 22ys changed CEA. ROA mealige (22Y).

Fig. 8

(A) CE: -10°, ROA: 35°, (B) Curette out of bone, (C) CE: 45°, ROA: 0°. amount of medialization: 20 mm (2 cm).

Fig. 9

(A) CE: -16°(reversed), ROA: 30°, (B) IR & Reduction, (C) RAO, (D) CE: 45°, ROA: 0°, (E) Post op 10ys, (F) Post op 25ys.

Fig. 10

Focal cartilage defect of the femoral head (Modification of Marvin E. Steinberg. The hip and Its Disorders, W. B. Saunders company, 1991:9.53).

Fig. 11

(A) CE: 10°, multiple columnar head cysts, (B) ROA: 30°, (C) Minimal lateral over rotation and 10 mm anterior rotation, (D) Post op, (E) CE: 45°ROA: +6°, (F) RAO 22ys (2009. 11): multiple head cysts.

Fig. 12

(A) CE; 10°RAO 30°, (B) curtain, floor osteophytes, (C) CE: 45°, (D) Post op 15ys, reversed ROA, medial shift.

Fig. 13

(A) head cysts, capital drop, floor osteophytes, (B) Post op, ROA reversed; 35°CE; 45°, (C) Post op 20ys(87ys).

Fig. 14

Bilateral cystic necrosis. (A) A cystic lesion occupies 1/2 of head, (B) Open head window, (C) gross specimem: fibromucoid tissue. (D) After autogenouse cancellous bone graft, catilage suture with 3.0 vicril, expecting Osteoinduction, Osteoconduction. (E) 16ys later operation of curettage head cyst and fill-up autogenous bone graft, Early radiolund cystic kissing lesion lesions in lateral edge acetabulum and femoral head. (F) Performed RAO on R hip for the cystic lesion of the Acetabulum (current & BG). (G) post op 10ys.

Fig. 15

(A) coalesent cysitic necrosis in femoral head, (B) MRI.

Fig. 16

(A) by the over rotation of Actabulum. We can get the full containment and coverage of femoral head and adequet medilaization (OP 2001. 12), (B) PO 5ys. (53ys. 2006).

Fig. 17

2011. 3. F/U 10y. 58ys. He is very active Golfer, Cellist.

Fig. 18

(A), (B) head cysts, capital drop, curtain osteophytes, (C) illustration of adequete lateral rotation and 10 mm anterior rotation (D) Post op 5ys.

Fig. 19

(A), (B), (C), (D), (E), (F) multi-columnar cysts are persisted longer period 14ys.

Fig. 20

(A) MED bilateral hip 18ys girl. (C) PO bilateral 16ys.

Fig. 21

(A), (B) Bilateral cystic necrosis & head collapsing, (C) multyple crilling and ingection of Autogenous marrow blood. (E) RAO containment of head & full coverage of Acetabulum. (F) After regeneration of F head. expecting fill up the remaining space by top osteoohyte from femoral head.

Fig. 22

The postero medial capital drop is utilized to weight bearing head surfece (paradigm shift).

Fig. 23

Valgus flexion Osteotomy. In Tokyo Seminar/March 16, 2004; Kitasato University Hospital. (A) Pre op. 52F, (B) 1yr, (C) 18yrs.

Fig. 24

(A) Preop. Hip Score-52 Roof Osteophyte, (B) 6mos. 45-o; HS=90, (C) 19yrs. HS=92.

Fig. 25

The arrows are points incredible potentiality of reparative process. (A) 64 F. 1977, (B) 4yrs, (C) 11yrs, (D) 14yrs.

Fig. 26

48y-o. Female: AHI=55% (A) Preop, (B) 1yr, (C) 15yrs.

Fig. 27

In case of unsperical head, coapt the articular surpace in pararell by valgus osteotomy of proximal femur and RAO of acetabular socket.

Fig. 28

1. roof, 2. superior cervical, 3. capital drop, 4. Curtain, 5. inferior cervical, 6. floor osteophyte.

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