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December 1, 2017The Journal of Hip SurgeryOpen Access

Successful Outcomes at Midterm Follow-up of Periacetabular Osteotomy Done for Mild Hip Dysplasia

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Key result

In patients undergoing periacetabular osteotomy, those with mild hip dysplasia had a 10.5% rate of conversion to total hip arthroplasty, which was not significantly different from the 9.2% rate observed in patients with severe hip dysplasia (p=0.69).

Why the study?

Does periacetabular osteotomy improve pain and function in patients with mild hip dysplasia comparably to those with severe hip dysplasia?

Population

182 hips in patients undergoing periacetabular osteotomy with ≥2 years of follow-up, average age 31 years…

Comparison

Periacetabular osteotomy for mild hip dysplasia vs Periacetabular osteotomy for severe hip dysplasia

Design

Cohort

Follow-up

mean 121 months for the MHD group

Authors

GPGuy D. PotterENEduardo N. NovaisRTRobert T. Trousdale

Discussion

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Member takes

Overview

PAO results in mild dysplasia warrant caution before adoption; leaves open comparative effectiveness versus arthroscopy.

Study Design

Type

Cohort (n=182)

Multicenter

No

Structured PICO

Does periacetabular osteotomy improve pain and function in patients with mild hip dysplasia comparably to those with severe hip dysplasia?

P
Population
182 hips in predominantly female patients (mean age 31 years) with symptomatic hip dysplasia who underwent periacetabular osteotomy, followed for a minimum of 2 years.
E
Exposure
Periacetabular osteotomy (PAO) for mild hip dysplasia (MHD)
C
Comparator
Periacetabular osteotomy (PAO) for severe hip dysplasia (SHD)
O
Outcome
Harris Hip Score (HHS), radiographic measurements, and survivorship free from total hip arthroplasty (THA)patient reported

Main Result

Absolute Event Rate: 10.5% vs 9.2%

p-value: p=0.69

Periacetabular osteotomy in patients with mild hip dysplasia provides durable improvements in pain and function comparable to outcomes in severe hip dysplasia at midterm follow-up.

Limitations

  • Lack of direct comparison to hip arthroscopy
  • Small sample size of the mild hip dysplasia group (n=19) suggesting selection bias
  • Use of arbitrary radiographic measurements to define mild hip dysplasia that may not capture dynamic instability

Cite This Study

Potter et al. (2017) conducted a cohort in Symptomatic hip dysplasia (n=182). Mild hip dysplasia vs. Severe hip dysplasia was evaluated on Conversion to total hip arthroplasty (THA) (p=0.69). In patients undergoing periacetabular osteotomy, those with mild hip dysplasia had a 10.5% rate of conversion to total hip arthroplasty, which was not significantly different from the 9.2% rate observed in patients with severe hip dysplasia (p=0.69).

synapsesocial.com/papers/6a658d94ce5d504482b6a334https://doi.org/10.1055/s-0038-1635102
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Why Do Hip Arthroscopy Procedures Fail?2013 · 237 citations
  2. 2Bernese Periacetabular Osteotomy in Males: Is There an Increased Risk of Femoroacetabular Impingement (FAI) After Bernese Periacetabular Osteotomy?2010 · 83 citations
  3. 3Mean 20-year Followup of Bernese Periacetabular Osteotomy2008 · 614 citations
  4. 4Complications Associated with the Periacetabular Osteotomy2014 · 167 citations