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Is pelvic support osteotomy (PSO) suitable for ordinary high−riding hip dysplasia?

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Abstract

Purpose

Pelvic support osteotomy (PSO) is regarded to provide pelvic stability and improve abductor function to delay or even avoid total hip arthroplasty (THA) in young patients with high-riding hip dysplasia. However, some of these patients eventually have to undergo THA. Because of the double-angulation deformity of the femur after PSO, subsequent THA is challenging. This study aimed to analyze whether PSO surgery is suitable for high-riding hip dysplasia and summarize orthopaedic strategy during THA for patients with previous PSO.

Methods

This case–control study included eight cases of THA for high-riding hip dysplasia patients with previous PSO (study group) and 24 cases of high-riding hip dysplasia patients without any hip surgical therapy (control group) by a 1:3 match (from May 2018 to January 2022). We compared demographics and joint function before and after THA between two groups and recorded all patients’ preoperative imaging data, surgical procedures, postoperative imaging data, and complications. The surgical techniques for patients with previous PSO were highlighted.

Results

There was no statistical difference between the two groups in demographic (p > 0.05). The study group had worse hip Harris score (HHS), range of motion (ROM), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (p < 0.05) compared with the control group before THA. All patients had concurrent THA and osteotomy at the proximal femur, but the study group experienced longer operation time (p = 0.047) with more blood loss (p = 0.027) and higher complication rate compared with the control group (p = 0.009). At the last follow-up, the study group’s HHS, ROM, VAS, and WOMAC were still worse than those in the control group.

Conclusions

PSO did not improve the joint function of high-riding hip dysplasia patients but brought challenges to subsequent THA and affected the surgical outcomes. In short, we suggested that PSO is unsuitable for routine high-riding hip dysplasia patients.

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Acknowledgements

We thank all authors who contributed to this work.

Funding

This study was funded by the National Natural Science Foundation of China (U22A20355).

Author information

Author notes

  1. Yijian Huang and Hongbin Xie contributed equally to this work and are co-first authors.

  2. Xiangpeng Kong and Wei Chai contributed equally to this work and are co-last authors.

Authors and Affiliations

  1. Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Beijing, 100048, China

    Yijian Huang, Hongbin Xie, Jiafeng Yi, Minzhi Yang, Xiangpeng Kong & Wei Chai

  2. Graduate School, Chinese PLA Medical School, Beijing, People’s Republic of China

    Yijian Huang & Minzhi Yang

  3. School of Medicine, Nankai University, Tianjin, 300071, China

    Hongbin Xie & Jiafeng Yi

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  1. Yijian Huang
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  4. Minzhi Yang
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Contributions

All authors have made substantial contributions to (1) the study conception and design (2) drafting and revising critically for important intellectual content, and (3) final approval of the submitted version. Xiangpeng Kong and Wei Chai were primarily responsible for the supervision of the research, including research protocol designing, data acquisition, and manuscript preparation. Yijian Huang and Hongbin Xie were mainly responsible for research design, data extraction, statistical analysis, article analysis, and manuscript drafting. Yijian Huang and Hongbin Xie contributed to this work equally and both of them were co-first authors. Jiafeng Yi and Minzhi Yang participated in data analysis and constructive discussions.

Corresponding authors

Correspondence to Xiangpeng Kong or Wei Chai.

Ethics declarations

Ethics approval

Ethical approval for this study was obtained from our institutional ethical committee (2023KY101-KS001). This study has been performed in accordance with the ethical standards in the 1964 Declaration of Helsinki. All details that might disclose the identity of the subjects under study had been omitted.

Conflict of interest

The authors declare no competing interests.

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Level of Evidence: Level III Case–control study (therapeutic and prognostic studies).

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Huang, Y., Xie, H., Yi, J. et al. Is pelvic support osteotomy (PSO) suitable for ordinary high−riding hip dysplasia?. International Orthopaedics (SICOT) (2024). https://doi.org/10.1007/s00264-024-06177-6

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  • DOI: https://doi.org/10.1007/s00264-024-06177-6

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