EARLY TO MID-TERM OUTCOMES OF PERIACETABULAR OSTEOTOMY FOR DEVELOPMENTAL HIP DYSPLASIA AND FEMOROACETABULAR IMPINGEMENT: A STUDY OF 1,087 CASES USING THE NAHR DATASET

Abstract

Periacetabular osteotomy (PAO) is an established treatment for developmental hip dysplasia (DDH) in young adults and can also be utilised in the management of femoroacetabular impingement (FAI) with acetabular retroversion. This study used a national registry to assess the outcomes of PAO for DDH and FAI.PAOs recorded in the UK Non-Arthroplasty Hip Registry between 2012 and November 2022 were identified along with recorded patient and surgical characteristics. Cases were grouped according to the primary pathology (DDH or FAI). Patient reported outcome measures (PROMs) captured included the International Hip Outcome Tool (iHOT)-12 (primary outcome) and the EuroQol-5 Dimensions (EQ-5D) index preoperatively and at 6 months, 1, 2, and 5 years post-operatively.1,087 PAOs were identified; 995 for DDH (91%), 98 for FAI (9%). Most patients (91%) were female. The DDH group were significantly older (mean 31.7 years) than the FAI group (25.4 years) but had similar body mass index (mean 25.7kg/m2). Overall, significant (all p<0.0001) iHOT-12 and EQ-5D improvement (delta) vs baseline pre-operative scores were achieved at 6 months (mean iHOT-12 improvement +27.4 (95%CI 25.3 to 29.5); n=515) and maintained out to 5 years (+30.0 (21.4 to 38.6); n=44 [9.8% of those eligible for follow-up at 5 years]), at which point 71% and 55% of patients continued to demonstrate a score improvement greater than or equal to the minimum clinically important difference (≥13 points) and substantial clinical benefit (≥28 points) for iHOT-12 respectively.This study demonstrates excellent functional outcomes following PAO undertaken for DDH and FAI in the short to medium term in a large national registry.