Protrusio acetabuli

Protrusio acetabuli is a medialisation of the medial wall of the acetabulum. The head of the femur lies medial to the Ilio-ischial or Kohler’s line.
Etiology-
1) Primary- Otto Pelvis (Arthrokatadysis)
2) Secondary-

Inflammatory arthritis-15% of Rh arthritis of the hip33% of ankylosing spondylitis of the hip
Metabolic-Osteomalacia – up to 50%Renal osteodystrophy, Hyperparathyroidism, Paget’s disease, Osteoporosis
Connective Tissue disorder Marfan’s, Erler-Danlos, Osteogenesis imperfecta
Traumatic-Central fracture-dislocation
Septic arthritis
Neoplastic
Existing Prosthesis, Hemi-arthroplasty
Seen in 5% of those with osteoarthritis

Clinical findings- Pain, Limp, stiffness

Treatment- In adults total hip replacement with or without bone grafting is required.
A novel form of replacement with the short stem Proxima hip replacement has been introduced by us -http://www.blog.hipsurgery.in/?p=462