Femoroacetabular impingement following an osteotomy for acetabular dysplasia: a commentary on a recently published study

Acetabular dysplasia (AD) is a common cause of hip pain in adolescents. Furthermore, compared to a normally shaped acetabulum, AD results in increased contact stresses due to the smaller weight bearing surface (1). These increased contact stresses are thought to contribute to damage to the labrum and cartilage, thus, increasing the chance of developing osteoarthritis later in life (1-3). In order to prevent this long term sequela, osteotomies have been used to treat AD (4). Two of these osteotomies include the Salter (5) innominate osteotomy and the Pemberton (6) pericapsular osteotomy (7,8). The salter osteotomy consists of stabilizing the reduced hip in the position of function by averting the acetabulum, whereas, the pericapsular osteotomy involves reshaping the dysplastic acetabulum. These two procedures have demonstrated good long-term results (8); however, there is the potential for overcorrection leading to iatrogenic pincer femoroacetabular impingement (FAI). With the development of FAI, some have proposed that this will lead to compression and shear stresses between the labrum and the cartilage, eventually also leading to articular degeneration and ultimately global hip OA (1). This question outlines the importance in publishing mid to long-term results following osteotomies to treat AD.