A minimally invasive periacetabular osteotomy improves the radiographic parameters and functional outcomes in the treatment of developmental dysplasia of the hip in adolescents and adults: surgical technique and early results.

Abstract

To introduce West China Hospital periacetabular osteotomy (WCH PAO) for acetabular dysplasia in adolescent and young adult patients and evaluate the early clinical results of WCH PAO. A retrospective analysis of 34 patients with developmental dysplasia of the hip was performed from October 2019 to April 2021. Baseline data with surgical time and perioperative blood-loss volume were retrieved from medical record systems. The lateral center-to-edge angle (LCEA), acetabular inclination (AI), hip disability and osteoarthritis outcome score (HOOS), University of California Los Angeles (UCLA), and modified Harris hip score (mHHS) were compared preoperatively and postoperatively. All patients had significant postoperative radiology improvements, including LCEA and AI. The LCEA was improved from 12.9 to 33.2°, and the AI was decreased from 27.2 to 8.5°. In addition, hip functional outcomes, including HOOS, UCLA and mHHS, were improved. The UCLA was improved from 3.9 to 6.3, and the HOOS was decreased from 71.0 to 10.5. The Harris hip score improved from 50.8 before surgery to 87.4 after surgery. The mean operative time was 155min (range 120 to 190min), and the mean intra-operative blood loss was 580.2 ± 285.5ml. Furthermore, no major complications, including nerve injury or bone nonunion, occurred in the cohort study. WCH PAO is a minimally invasive surgical method for acetabular dysplasia in adolescent and young adult patients who that simplifies the surgical procedure and decreases the incidence of complications related to osteotomy.