Is Femoral Head Decentration Reversible After Periacetabular Osteotomy for the Treatment of Developmental…

Cohort studyClinical orthopaedics and related research· Aug 2026

Is Femoral Head Decentration Reversible After Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip?

Florian Schmaranzer, Alexander F Heimann, Michael B Millis … Eduardo N Novais

Pediatric OrthopedicsCohort studyPrognosis

Femoral head decentration persisted in most hips one year after periacetabular osteotomy for developmental dysplasia of the hip.

Is Femoral Head Decentration Reversible After Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip?

Florian Schmaranzer … Eduardo N Novais

Clinical orthopaedics and related research · Aug 2026

Background

Femoral head decentration, seen on MRI as a fluid gap between the femoral head and acetabulum, has recently been introduced as a sign of hip instability.

Purpose

(1) Does femoral head decentration, femoral head decentration distance, and its radial extension decrease after periacetabular osteotomy for treatment of developmental dysplasia of the hip?

Methods

We performed a secondary retrospective analysis of a prospectively collected cohort of 34 patients (34 hips) undergoing isolated periacetabular osteotomy for symptomatic developmental dysplasia of the hip (lateral center-edge angle < 20°).

n = 34 patients

Results

20

of 29

most hips with preoperative decentration still had it a year after surgery, only a minority resolved

n = 34 patients

More results

Preoperatively, hips with persistent femoral head decentration exhibited higher median femoral anteversion (22° versus 10°; p = 0.01) and a higher preoperative acetabular index (24° versus 15°; p = 0.01) compared with hips in which femoral head decentration resolved.

More results

Biochemical cartilage health was worse in the persistent group, with a lower median dGEMRIC index (436 msec versus 606 msec; p = 0.004).

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Conclusion · 1 of 2

Although periacetabular osteotomy reduced the magnitude and extent of femoral head decentration, complete anatomic resolution occurred in only about one-third of patients with complete follow-up, and it may be less frequent among patients lost to follow-up.

Conclusion · 2 of 2

Persistent femoral head decentration after periacetabular osteotomy was present in hips with excessive femoral anteversion and advanced intraarticular degeneration, including severe cartilage loss, subchondral cysts, and labral lesion.

Is Femoral Head Decentration Reversible After Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip?

Is Femoral Head Decentration Reversible After Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip?

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