Background Satisfactory long-term results of periacetabular osteotomy (PAO) for the treatment of coxarthrosis have been reported. The purpose of this study was to examine the results of PAO in patients with advanced coxarthrosis with huge cysts caused by acetabular dysplasia. Methods We prospectively analyzed ten hips in ten patients treated for bone cysts larger than 1.5 cm who underwent the Bernese PAO with bone grafts performed by a single surgeon. The average age of the patients at the time of surgery was 45.9 years, and the average duration of clinical follow-up was 23.9 years. The Japanese Orthopaedic Association (JOA) hip score was used and overall patient satisfaction with surgery was evaluated to assess hip function and clinical results. Plain radiographs were used to determine correction of deformity and progression of degenerative arthritis. Results The mean pain score and the mean JOA hip score improved postoperatively. Radiographic analysis demonstrated consistent deformity correction and significant improvements in the AHI and anterior acetabular head index with no recurrence of the cystic lesion. Range of motion decreased and degenerative arthritis worsened in some cases with relative joint space narrowing and huge cyst. Five patients have required the total hip replacements. Conclusions PAO for the coxarthrosis with huge cysts improves hip function and may prevent or delay progression of degenerative arthritis in most patients. We must consider the indications and technique of PAO for the treatment of coxarthrosis when severe joint space narrowing is observed before surgery or when the cysts are larger than 3 cm.
Chosa et al. (Thu,) studied this question.