Abstract
BackgroundRotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for adulthood hip dysplasia (AHD). Despite sufficient correction of acetabular dysplasia, some patients still experience osteoarthritis (OA) progression and require total hip arthroplasty (THA). The purposes of the current study were to investigate the survival rate and the risk factors for OA progression or THA requirement after RAO and to explore whether acetabular overcorrection relates to OA progression.MethodsFifty-six patients (65 hips, mean age: 36.5 ± 11.7 years) with AHD who underwent RAO and were followed up for >10 years (mean: 15.0 ± 3.2 years) were enrolled in this study. A Kaplan-Meier survival analysis was performed to assess the non-OA progression rate and THA-free survival rate of RAO during the 10-year follow-up. To analyze the risk factors for OA progression and THA requirement, the Cox proportional hazards regression analysis was performed.ResultsNo OA progression was found in 76.7% of the patients, and THA was not required in 92.3% during the 10-year follow-up. By multivariate regression analysis, older age at the time of surgery was a risk factor for both OA progression (hazard ratio [HR] = 1.047, 95% confidence interval [CI] = 1.005–1.091) and THA requirement (HR = 1.293, 95% CI = 1.041–1.606).ConclusionRAO is an effective surgical procedure for symptomatic patients with AHD that prevents OA progression and protects the hips from undergoing THA. However, older patients have a higher risk for both OA progression and THA requirement.
Highlights
Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for adulthood hip dysplasia (AHD)
Rotational acetabular osteotomy (RAO) is a jointpreserving periacetabular osteotomy technique [4,5,6,7,8] developed by Ninomiya and Tagawa [9] that corrects insufficient femoral coverage by rotating the acetabular roof with an articular cartilage
Undercorrection of the acetabular roof may result in instabilities of the hip joint, Tomioka et al BMC Musculoskeletal Disorders (2017) 18:191 and efficient coverage of the acetabular roof to the femoral head is essential in this procedure
Summary
Rotational acetabular osteotomy (RAO) is an effective joint-preserving surgical treatment for adulthood hip dysplasia (AHD). Despite sufficient correction of acetabular dysplasia, some patients still experience osteoarthritis (OA) progression and require total hip arthroplasty (THA). The purposes of the current study were to investigate the survival rate and the risk factors for OA progression or THA requirement after RAO and to explore whether acetabular overcorrection relates to OA progression. Dysplastic acetabular roof induces instability and incongruence of the hip joints at an early age that trigger the progression of hip OA and may require total hip arthroplasty (THA) even in young- or middle-aged patients. Since THA for young- or middle-aged active patients is associated with high rates of loosening [2, 3], joint-preserving operations are an important surgical option. Association of overcorrection and OA progression after RAO was rarely investigated previously [6, 12]
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