The role of different acetabular morphologies on patient-reported outcomes following periacetabular osteotomy in borderline hip dysplasia.
Arch Orthop Trauma Surg
; 144(7): 3073-3081, 2024 Jul.
Article
en En
| MEDLINE
| ID: mdl-38967778
ABSTRACT
INTRODUCTION:
The treatment option for borderline hip dysplasia (BHD) includes hip arthroscopy and periacetabular osteotomy (PAO). To the present day the controversial discussion remains, which intervention to prefer. Literature reports supporting an educated choice are scare, based on small patient cohorts and do not address the variability of acetabular morphology. Consequently, we intended to report PAO outcomes, from patients diagnosed with BHD, dependent on acetabular morphology, in a large patient cohort and aimed to define risk factors for poor clinical results and patient satisfaction. MATERIALS ANDMETHODS:
A prospective monocentre study was conducted. Patients enrolled underwent PAO for symptomatic BHD (LCEA, 18°-25°). A total of 107 hips were included with 94 complete data sets were available for evaluation with a minimum follow-up of 1 year and a mean follow-up of 2.3 years. The mean age was 31 ± 8.2 years, and 81.3% were female. As the primary outcome measure, we utilized the modified Harris hip score (mHHS) with minimal clinically important change (MCID) of eight to define clinical failure. Results were compared after a comprehensive radiographic assessment distinguishing between lateral deficient vs. anterior/posterolateral deficient acetabular and stable vs. unstable hip joints.RESULTS:
Overall, clinical success was achieved in 91.5% of patients and the mHHS improved significantly (52 vs. 84.7, p < 0.001). Eight hips failed to achieve the MCID and four had radiographic signs of overcorrection. Comparing variable joint morphologies, the rate of clinical success was higher in patients with an anterior/posterolateral deficient acetabular covarage compared to lateral deficient acetabular (95.2% vs. 90.4%). tThe highest rate of clinical failure was recorded in unstable hip joints (85.7% vs. 92.5% in stable hips).CONCLUSIONS:
This study demonstrates that PAO is an effective means to treat symptomatic BHD with variable acetabular morphologies, achieving a clinical success in 91.5% of all patients. To maintain a high level of safety and patient satisfaction technical accuracy appears crucial.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Osteotomía
/
Medición de Resultados Informados por el Paciente
/
Acetábulo
Límite:
Adult
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Female
/
Humans
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Male
Idioma:
En
Revista:
Arch Orthop Trauma Surg
Año:
2024
Tipo del documento:
Article
País de afiliación:
Alemania