, Volume 470, Issue 9, pp 2583-2590
Date: 29 Mar 2012

Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery

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Topic
Hip

Abstract

Background

Although the success of the Bernese periacetabular osteotomy (PAO) has been reported for primary dysplasia, there is no study analyzing the radiographic, functional, and gait results of the PAO to correct residual hip dysplasia after previous pelvic surgery.

Questions/purposes

We assessed (1) radiographic and (2) functional and gait outcomes of patients treated with a PAO after previous pelvic surgery (PPSx) and compared their results with results of patients with no previous surgery (NPSx) to determine whether the PAO was equally effective in patients with revision pelvic surgery.

Methods

Twenty-nine dysplastic hips in 26 patients (average age, 16.3 years) were included: 13 in the PPSx group and 13 in the NPSx group. Radiographic parameters included the lateral center-edge angle, acetabular index, and femoral head extrusion index measured preoperatively and at 6 months and 1 year. We assessed preoperative and postoperative function using the Harris hip score (HHS). Preoperative and postoperative gait analysis included the hip abductor impulse.

Results

Improvements in groups were seen from preoperatively to 1 year postoperatively for the lateral center-edge angle, acetabular index, and femoral head extrusion index without differences between groups. The modified HHSs improved at 6 months and were maintained at 1 year for patients in both groups without differences between groups. The hip abductor impulse returned to preoperative values at 6 months in the NPSx group but not until 1 year in the PPSx group.

Conclusions

The Bernese PAO is effective in providing similar final radiographic and functional results, however, a trend toward decreased hip flexion and abduction power at 1 year was seen with previous pelvic surgery.

Level of Evidence

Level II, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Each author certifies that he or she, or a member of his or her immediate family, has no commercial associations (eg consultancies, stock ownership, equity interest, patent/licensing arrangement, etc) that might pose a conflict of interest in connection with the submitted article.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.