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Factors predicting the failure of Bernese periacetabular osteotomy: a meta-regression analysis

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Abstract

There is no clear evidence regarding the outcome of Bernese periacetabular osteotomy (PAO) in different patient populations. We performed systematic meta-regression analysis of 23 eligible studies. There were 1,113 patients of which 61 patients had total hip arthroplasty (THA) (endpoint) as a result of failed Bernese PAO. Univariate analysis revealed significant correlation between THA and presence of grade 2/grade 3 arthritis, Merle de’Aubigne score (MDS), Harris hip score and Tonnis angle, change in lateral centre edge (LCE) angle, late proximal femoral osteotomies, and heterotrophic ossification (HO) resection. Multivariate analysis showed that the odds of having THA increases with grade 2/grade 3 osteoarthritis (3.36 times), joint penetration (3.12 times), low preoperative MDS (1.59 times), late PFO (1.59 times), presence of preoperative subluxation (1.22 times), previous hip operations (1.14 times), and concomitant PFO (1.09 times). In the absence of randomised controlled studies, the findings of this analysis can help the surgeon to make treatment decisions.

Résumé

Le devenir de l’ostéotomie péri-acétabulaire Bernoise n’est pas évident. nous avons réalisé une méta analyse sur 23 études regroupant 1113 patients sur lesquels 61 patients ont nécessité du fait de l’échec de l’ostéotomie une prothèse totale. une analyse univariable montre une corrélation significative entre la prothèse et la présence d’une arthrose de grade 2 ou 3, le score de Merle d’Aubigne, le score de Harris, l’angle de Tonnis, les modifications de l’angle LCE, les ostéotomies fémorales tardives, la résection d’ossifications. L’analyse multivariable montre, qu’il y a 3,36 fois plus de chances d’avoir une arthrose s’il existe une arthrose de grade 2 ou 3, 12% s’il existe une pénétration articulaire, 1,09% si le score MDS est relativement bas, l’interpénétration articulaire 3,12 fois, le score de Merle d’Aubigné très bas 1,59 fois, une ostéotomie fémorale tardive 1,59 fois, une subluxation préopératoire 1,22 fois, une intervention préalable au niveau de la hanche 1,14 fois, une ostéotomie proximale fémorale concomitante 1,09 fois. Cette analyse permet au chirurgien de prendre des décisions thérapeutiques.

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Authors and Affiliations

  1. Department of Orthopaedics, VCUHS, West Hospital 9th floor, North Wing, Richmond, VA, 23298, USA

    Senthil Nathan Sambandam, Jason Hull & William A. Jiranek

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  1. Senthil Nathan Sambandam
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  2. Jason Hull
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  3. William A. Jiranek
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Correspondence to Senthil Nathan Sambandam.

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Sambandam, S.N., Hull, J. & Jiranek, W.A. Factors predicting the failure of Bernese periacetabular osteotomy: a meta-regression analysis. International Orthopaedics (SICOT) 33, 1483–1488 (2009). https://doi.org/10.1007/s00264-008-0643-7

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  • DOI: https://doi.org/10.1007/s00264-008-0643-7

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