Acetabular dysplasia: a comparison of periacetabular osteotomy results of patients older and younger than 35 years.

Abstract

Patient age has been reported to be an important determinant of treatment success in developmental dysplasia of the hip (DDH). This study aimed to determine the efficacy of periacetabular osteotomy (PAO) in DDH patients aged ≥ 35 years and to compare patient-reported and radiological outcomes with a control cohort of younger patients. This retrospective analysis included 43 patients (23 aged < 35 years; 20 aged ≥ 35 years) who underwent unilateral Bernese PAO for symptomatic DDH, between May 2001 and August 2015. Patients with a history of ipsilateral pelvic osteotomy or other pelvic pathologies were excluded. To evaluate the morphology of the dysplastic hip joints, 11 conventional radiographic measures were taken. Preoperative and postoperative Harris Hip Scores, postoperative visual analogue scale scores, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, and hip range of motion measurements were used for clinical evaluation. Of the 43 patients, 31 (72.1%) were women and 14 (27.9%) were men. The average age was 32 (range: 19-45) years. Regarding sex, surgery site, mean body mass index and mean follow-up time, there were no significant differences between the groups. Both groups showed significant differences in radiographic parameters before and after the PAO. There were no significant differences in preoperative or postoperative clinical outcomes between the groups, except for the WOMAC score. PAO can be performed safely to treat acetabular dysplasia in patients aged ≥ 35 years, before the onset of femoroacetabular osteoarthritis, with satisfactory clinical and functional outcomes.