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Mean 20-year Followup of Bernese Periacetabular Osteotomy

  • Original Article
  • Hip
  • Published:
Clinical Orthopaedics and Related Research

Abstract

The goal of the Bernese periacetabular osteotomy is to correct the deficient acetabular coverage in hips with developmental dysplasia to prevent secondary osteoarthrosis. We determined the 20-year survivorship of symptomatic patients treated with this procedure, determined the clinical and radiographic outcomes of the surviving hips, and identified factors predicting poor outcome. We retrospectively evaluated the first 63 patients (75 hips) who underwent periacetabular osteotomy at the institution where this technique was developed. The mean age of the patients at surgery was 29 years (range, 13–56 years), and preoperatively 24% presented with advanced grades of osteoarthritis. Four patients (five hips) were lost to followup and one patient (two hips) died. The remaining 58 patients (68 hips) were followed for a minimum of 19 years (mean, 20.4 years; range, 19–23 years) and 41 hips (60%) were preserved at last followup. The overall mean Merle d’Aubigné and Postel score decreased in comparison to the 10-year value and was similar to the preoperative score. We observed no major changes in any of the radiographic parameters during the 20-year postoperative period except the osteoarthritis score. We identified six factors predicting poor outcome: age at surgery, preoperative Merle d’Aubigné and Postel score, positive anterior impingement test, limp, osteoarthrosis grade, and the postoperative extrusion index. Periacetabular osteotomy is an effective technique for treating symptomatic developmental dysplasia of the hip and can maintain the natural hip at least 19 years in selected patients.

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

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Authors and Affiliations

  1. Department of Orthopaedic Surgery, Inselspital, University of Bern, Murtenstrasse, 3010, Bern, Switzerland

    Simon D. Steppacher MD, Moritz Tannast MD, Reinhold Ganz MD & Klaus A. Siebenrock MD

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  1. Simon D. Steppacher MD
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  2. Moritz Tannast MD
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  3. Reinhold Ganz MD
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  4. Klaus A. Siebenrock MD
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Correspondence to Moritz Tannast MD.

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One or more of the authors (SDS, MT, KAS) have received funding from the National Center for Competence in Research “Co-Me” of the Swiss National Science Foundation.

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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Steppacher, S.D., Tannast, M., Ganz, R. et al. Mean 20-year Followup of Bernese Periacetabular Osteotomy. Clin Orthop Relat Res 466, 1633–1644 (2008). https://doi.org/10.1007/s11999-008-0242-3

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