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Long-term results of Bernese periacetabular osteotomy using a dual approach in hip dysplasia

  • Orthopaedic Surgery
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Abstract

We report the long-term results of Bernese periacetabular osteotomy using a dual approach in hip dysplasia. Fifty-three hips (49 patients, mean age 39.9 years: 13–62 years; bilateral hips: four patients) that underwent periacetabular osteotomy using a dual approach (combined Smith–Peterson and Kocher–Langenbeck techniques) between May 1997 and December 2005 were analyzed in this study. The clinical and radiologic outcomes and complications were analyzed and the final survival rates of the operated hips were investigated with survival analysis curves. Forty-nine hips survived until the final follow-up without arthroplasty, and four hips underwent arthroplasty. The average follow-up period was 11.5 years (8–16 years). The pain visual analogue scale improved from 6.3 to 1.1, while the Harris hip score improved from 61.9 to 91.1. Radiologic findings showed that all cases showed improvements in the center edge angle, acetabular angle, acetabular depth, and femoral head coverage. Two patients underwent intraarticular osteotomy due to a complication, and one patient underwent additional osteotomy due to an under-correction. Three cases showed an asymptomatic nonunion of the superior pubic ramus osteotomy site. One patient developed an avulsion fracture of the anterior superior iliac spine, and none of the cases had an infection or permanent neurologic damage. Kaplan–Meier analysis revealed that the 10-year survival rate was 93% (95% confidence interval [CI] 81–98%) with arthroplasty as the endpoint and 86% (95% CI 70–91%) with the progression of osteoarthritis based on Tönnis osteoarthritis rating as the endpoint. Based on the outcomes of a long-term follow-up of more than 10 years on average, Bernese periacetabular osteotomy via a dual approach was found to be a satisfactory method for lowering the incidence of complications while preserving hips.

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Chungbuk National University College of Medicine, Cheongju, Republic of Korea

    Hyun Chul Shon & Woo Sung Park

  2. Department of Orthopaedic Surgery, Asan Medical Center, Ulsan University College of Medicine, Seoul, Republic of Korea

    Jae-Suk Chang

  3. Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, Bundang, Republic of Korea

    Seong-Eun Byun

  4. Department of Orthopaedic Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea

    Dong-Wook Son, Sang Hoon Ha, Ki Tae Park & Jai Hyung Park

  5. Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea

    Hee Jin Park

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  1. Hyun Chul Shon
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Shon, H.C., Park, W.S., Chang, JS. et al. Long-term results of Bernese periacetabular osteotomy using a dual approach in hip dysplasia. Arch Orthop Trauma Surg 143, 591–602 (2023). https://doi.org/10.1007/s00402-021-04090-w

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