Results of following-up for 5-10 years of periacetabular osteotomy for acetabular dysplasia in adolescence

Abstract

To investigate the effects of periacetabular osteotomy (PAO) for developmental dysplasia of the hip in adolescent. Twelve hips in 9 adolescent patients who underwent a Bernese periacetabular osteotomy for symptomatic or asymptomatic developmental dysplasia of the hip were analyzed. The average age of the patients at the time of surgery was 12.9 years(11-14 years). The Harris hip score and overall patient satisfaction with surgery were used to assess hip function and clinical results. Plain radiographs were used to assess the correction of the deformity and to observe progression of degenerative changes. The average duration of clinical follow-up was 88.5 (60-136) months. The mean Harris hip score increased from 89 ± 6 preoperatively to 97 ± 3 at the time of the most recent follow-up (t = -6.754, P = 0.000). All patients (12 hips) had an excellent clinical result. The lateral center-edge angle of Wiberg increased from 4° ± 13° preoperatively to 36° ± 7° at the time of the most recent follow-up (t = -11.677, P = 0.000). The acetabular roof obliquity decreased from 28° ± 10° preoperatively to 2° ± 8° at the time of the most recent follow-up (t = 9.038, P = 0.000). The acetabular-head index increased from 54% ± 11% preoperatively to 89% ± 13% at the time of the most recent follow-up (t = -11.137, P = 0.000). The hip center was translated medially. Improvement of cystic degeneration of the acetabulum were found in 4 hips. Remodeling of aspherical uncongruence were found in 5 cases. Crossing sign were found in 2 hips postoperatively without symptoms of impingement. PAO can provide comprehensive deformity correction and improve hip function in treatment of developmental dysplasia of the hip in adolescence. Some of the patients have improvement of cystic degeneration and remodeling of the hip.