Patient Consent for Peri-Acetabular Osteotomy

Undergoing a Peri-Acetabular Osteotomy for Dysplasia of the hip is a complex procedure and all the risks associated with any open procedure apply.

Specifically the following:

1. Risk of blood loss needing a transfusion. We avoid this in most cases by using cell saver. This a technique whereby the blood lost is sucked through a system of filters and washed prior to reinfusion. Approximately half the volume lost is returned.
2.  Performing an osteotomy (Bone cuts) around the hip socket is a complex procedure and the risks are  propagation of the bone cuts and/or joint penetration. This will compromise the result of the operation. Fortunately this is rare but unique to this procedure.
3.  These bone cuts are all done in close proximity to nerves and vessels traversing the pelvis toward the leg. Damage to these structures can have permanent consequence.
4.  Following the bone cuts and setting the orientation of the socket in the correct position is a precise requirement done under direct vision and aided with fluoroscopy (real time X-Rays in theatre). Sometimes due to the dynamic nature of pelvic movement future arthroscopic refining may be needed.
5. The bone needs to unite and some of the cuts may not (non-union or delayed union). This may also require reoperation to bone graft.

These are quite daunting possible complications and the overall risk is about 6%.  Outcomes are very dependent upon the initial state of the cartilage and the severity of the dysplasia. This will be discussed individually of course.