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Clinical Orthopaedics and Related Research®

, Volume 471, Issue 2, pp 498–503 | Cite as

Prevalence and Treatment of Intraarticular Pathology Recognized at the Time of Periacetabular Osteotomy for the Dysplastic Hip

  • John G. Ginnetti
  • Christopher E. Pelt
  • Jill A. Erickson
  • Christin Van Dine
  • Christopher L. Peters
Symposium: Papers Presented at the Annual Meetings of The Hip Society

Abstract

Background

The indication for hip arthrotomy accompanied by intraarticular work during periacetabular osteotomy (PAO) has not been precisely defined. To validate a role for routine hip arthrotomy accompanied by intraarticular work, frequent intraarticular pathology must exist, and the adjunct procedures must not be associated with inferior relief of pain, reduced function, radiographic osteoarthritis progression, or conversion to THA.

Questions/purposes

(1) What is the prevalence of intraarticular pathology at the time of PAO? (2) Does concomitant hip arthrotomy with associated intraarticular work negatively affect PAO as reflected by differences in Harris hip scores (HHS), Tönnis grade, and failure rates?

Methods

We retrospectively reviewed the intraarticular findings in all 151 patients who underwent PAO accompanied by routine hip arthrotomy and intraarticular work from 2002 to 2009. Using multivariate regression models, we compared the HHS and Tönnis grades of patients receiving arthrotomy with a cohort of 39 patients who received PAO alone.

Results

The overall prevalence of intraarticular pathology identified during PAO was 89%. Eight (5.3%) failures were identified within the arthrotomy cohort with mean postoperative HHS, postoperative Tönnis grade, postoperative change in HHS, and postoperative change in Tönnis grade of 87.5, 0.7, 29.8, and 0.3, respectively. By contrast, seven (17.9%) failures were identified in the nonarthrotomy cohort. The mean postoperative HHS, postoperative Tönnis grade, postoperative change in HHS, and postoperative change in Tönnis grade for the nonarthrotomy cohort were 83.1, 1.3, 19.0, and 0.3, respectively.

Conclusions

We believe the high prevalence of intraarticular pathology is sufficient to warrant routine joint inspection at the time of PAO. Hip arthrotomy accompanied by intraarticular work at the time of PAO is safe and does not impose additional patient morbidity.

Level of Evidence

Level III, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Keywords

Acetabular Dysplasia Acetabular Index Periacetabular Osteotomy Acetabular Retroversion Femoral Head Coverage 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgments

We thank Jeremy Gililland MD for his contribution to the statistical analysis.

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Copyright information

© The Association of Bone and Joint Surgeons® 2012

Authors and Affiliations

  • John G. Ginnetti
    • 1
  • Christopher E. Pelt
    • 1
  • Jill A. Erickson
    • 1
  • Christin Van Dine
    • 1
  • Christopher L. Peters
    • 1
  1. 1.University of UtahSalt Lake CityUSA

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