Clinical Orthopaedics and Related Research®

, Volume 467, Issue 9, pp 2228–2234

Periacetabular Osteotomy for Acetabular Dysplasia in Patients Older than 40 Years: A Preliminary Study

Authors

    • Adolescent and Young Adult Hip UnitChildren’s Hospital Boston, Harvard Medical School
  • Michael Kain
    • Adolescent and Young Adult Hip UnitChildren’s Hospital Boston, Harvard Medical School
  • Rafael Sierra
    • Mayo Clinic
  • Robert Trousdale
    • Mayo Clinic
  • Michael J. Taunton
    • Mayo Clinic
  • Young-Jo Kim
    • Adolescent and Young Adult Hip UnitChildren’s Hospital Boston, Harvard Medical School
  • Scott B. Rosenfeld
    • Adolescent and Young Adult Hip UnitChildren’s Hospital Boston, Harvard Medical School
  • Ganesh Kamath
    • Washington University School of Medicine
  • Perry Schoenecker
    • Washington University School of Medicine
  • John C. Clohisy
    • Washington University School of Medicine
Symposium: Papers Presented at the Annual Closed Meeting of the International Hip Society

DOI: 10.1007/s11999-009-0824-8

Cite this article as:
Millis, M.B., Kain, M., Sierra, R. et al. Clin Orthop Relat Res (2009) 467: 2228. doi:10.1007/s11999-009-0824-8

Abstract

The functional outcomes of periacetabular osteotomy (PAO) and factors predicting outcome in the older patient with acetabular dysplasia are not well understood. We therefore retrospectively determined the functional outcome of 70 patients (87 hips) over age 40 treated with PAO in three institutions; we also determined whether preoperative factors, particularly the presence of osteoarthritis, influenced the survival of the hip or time to total hip arthroplasty after PAO. The average age at surgery was 43.6 years. The minimum followup was 2 years (mean, 4.9 years; range, 2–13 years). Twenty-one hips (24%) had undergone total hip arthroplasty (THA), at a mean of 5.2 years after PAO (range, 1.9–7.6 years). Surviving hips had a mean improvement in Harris hip score from 60.7 to 90.3 and in total WOMAC pain score from 8.7 to 3. We observed no differences in preoperative or postoperative radiographic measurements or preoperative clinical function scores (HHS, WOMAC) in hips surviving and hips having THA. The risk of THA at 5 years after PAO was 12% in hips with preoperative Tönnis Grade 0 or 1 and 27% for Tönnis Grade 2. Our preliminary study suggests that PAO will give satisfactory functional and pain scores in patients over age 40 having dysplastic hips with mild or no arthrosis.

Level of Evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Copyright information

© The Association of Bone and Joint Surgeons 2009