Capsular augmentation in Colonna arthroplasty for the management of chronic hip dislocation

Figures

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  Fig. 1.. Pre-operative imaging: (A) anteroposterior (AP) pelvis X-ray. (B) Left hip AP and lateral X-ray. (C) Right and left hip false profile views. (D) Bilateral leg-length scanogram. (E) Pelvis CT axial cuts. The calculated femoral anteversion was 9°. (F) Left hip CT 3D reconstructions. (G) Left hip MRI arthrogram demonstrating low hip capsule volume despite high dislocation. (H) AP pelvis with preoperative template for native acetabulum location, trochanteric osteotomy, and possible femoral shortening osteotomy.

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  Fig. 2.. Exposure of the intact articular cartilage of the femoral head.

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  Fig. 3.. Stay sutures placed in each corner of the dermal allograft to allow appropriate tensioning and positioning within the acetabulum during the final femoral head reduction maneuver.

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  Fig. 4.. Femoral head reduced via a parachute of interposed dermal allograft. The superior rim shelf autograft affixed with two screws is also visible. Cranial side of body is to the right of the image.

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  Fig. 5.. Post-operative X-rays. (A) Intra-operative left hip AP fluoroscopic view demonstrating adequate femoral head reduction. (B) Post-operative AP pelvis X-ray in hip abduction brace. (C) 8-Month post-operative AP pelvis X-ray.