137.
Clinical and radiological outcome after periacetabular osteotomy
operated in the period 1999-2008. - Predictors for good results or
conversion to Total Hip Arthroplasty.
Dahl Line Borreskov, Dengsø Kristine , Petersen Michael Mørk, Christensen
Karl Bang, Stürup Jens
Department of Orthopaedic Surgery Rigshospitalet, University of Copenhagen,
Denmark; Department of Orthopaedic Surgery, Rigshospitalet, University of
Copenhagen, Denmark; Department of Orthopaedic Surgery, Rigshospitalet,
University of Copenhagen, Denmark; Biostatistic Department, Institut for
Folkesundhedsvidenskab; Department of Orthopaedic Surgery, Rigshospitalet,
University of Copenhagen, Denmark
Background:
Few papers have described results after periacetabular
osteotomy (PAO) and predictors for conversion to total hip arthroplasty
(
THA).
Purpose / Aim of Study:
To analyse clinical and radiographic outcome,
survival of the hip joint and predictors of poor outcome in patients with PAO
performed at the department of orthopaedics at Rigshospitalet.
Materials and Methods:
In the period of 1999 – 2008, 127 hips (median age
31,
range 13-49 years) were operated on with PAO. Median follow up was 6.8
(
range 0.7-11.6) years. Analyses of clinical and radiographic examinations
were performed including WOMAC and EQ-5D. Survival was assessed by
Kaplan-Meier and predictors of conversion to THA were calculated using Cox
regression analysis with THA and WOMAC – pain score > 10 as defined
endpoints. Osteoarthritis was assessed using Tönnis grade.
Findings / Results:
Center Edge Angle (CE Angle) and Acetabular roof
obliquity angle (AA angle) improved significantly with a mean of 8.7 (95%CI:
7.1; 10.3)
preoperatively to 24.6 (95%CI: 22.6; 26.6) at follow up, and a mean
of 26.1 (95%CI: 19.7: 22.6) preoperatively to 8.7 (95%CI: 7.1; 10.4) at follow-
up. Eleven out of 127 hips had conversion to THA. The 10.6 years cumulated
hip joint survival rate was 84.9%. Significant predictors of converting to THA
were preoperative high grade of OA, postoperative high degree of AA angle
and joint space width at follow-up. An improvement was found in HHS pain
score after receiving a PAO (p=0.007). EQ-5D was roughly at the same level
as in the Danish population without hip dysplasia.
Conclusions:
Our results with 10 years survival are comparable with the
literature. PAO is considered as an effective treatment for young adults with
painful hip dysplasia. Especially when preoperative criteria for conversion to
THA are illuminated.
