الفهرس 
Review of LiteratureOnly 14 pages are availabe for public view
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Abstract
Resulting Developmental dysplasia of the hip (DDH) is a developmental disorder of hip joint in dysplasia of the hip joint, possible sublaxation or dislocation of the hip.DDH is the cause of acetabular dysplasia & osteoarthritis in 20%- 40% of patients with OA of hip. Patients presented with acetabular dysplasia in periadolecent period and young adults are either failed treatment in childhood, neglected or late onset development with mild progression of disease.
One of the most important ways of management is hip preservation therapy to prevent progression of disease, protect against OA of hip, and delay need for THR. Different surgical techniques have been showed to manage acetabular dysplasia in adolescents and young adults. Choice of surgical techniques depend on different factors including age, ossification of triradiate cartilage, degree of affection of hip joint capsule, labrum and articular cartilage and degree of acetabular dysplasia which is determined radilologically and clinically.
In 1988, Ganz et al. published his new technique of osteotomy to manage acetabular dysplasia. It allows extensive acetabular reorientation including medial displacement to improve femoral head coverage and normalize loading of the anterolateral acetabular rim and to medialize the centre of the hip joint. This procedure is used most commonly in adolescents when the triradiate cartilage is nearly closed. periacetabular osteotomy (PAO) with orthogonal cuts, leaving the posterior column intact and not affecting the shape of the true pelvis, this osteotomy allows earlier weightbearing through preservation of an intact posterior column and a more aggressive rehabilitative approach.
This review aimed to assess efficacy of PAO in management of acetabular dysplasia and compare its results with results of other reorientation osteotomies, reshaping osteotomies and salvage procedures regarding functional, clinical improvement, radiological parameters (LCEA, AI) improvement, follow up as regard development of OA and post-operative complications.
PAO appears to achieve good to excellent results in management of acetabular dysplasia as regards functional and clinical improvement which was assessed by either HHS or Merle D’ Aubigne score which showed improve ment of scores in comparison to pre-operative time and also in comparison to other surgical techniques.
In radiological parameters, this review make radiological assessment based on LCEA, AI which showed significant improvement in mean change postoperatively rather than preoperatively.
As regard follow up, PAO had showed best results with least percentage to develop early OA if done before severe progression of arthritic changes in hip joint.
Although PAO had shown better results in management of acetabular dysplasia in adolescents and young adults, it is considered high technically demanding technique and require high learning curve so it had shown higher rate of complications in comparison to other techniques which are LFCN palsy, Heterotropic ossification, infection and malunion of osteotomies.
In 2015, chen etal, had done comparative study between isolated PAO and combined PAO + Arthroscopy in management of patients with acetabular dysplasia in adolescents and young adults, it showed better results with isolated acetabular osteotomy as regard clinical, functional and radilogical improvenment except in cases with associated labral tears, loose bodies and osteochondral defect, arthroscopy had showed better improvement clinically and functionally.