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Is cup positioning challenged in hips previously treated with periacetabular osteotomy?
Charlotte Hartig-Andreasen1, Maiken Stilling1, Kjeld Søballe2
1Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.
The Journal of Arthroplasty
|September 17, 2013
Summary
Total hip arthroplasty after periacetabular osteotomy yields excellent outcomes. However, surgeons must recognize and address persisting hip dysplasia to avoid excessive cup abduction during total hip arthroplasty.
Area of Science:
- Orthopedic Surgery
- Hip Reconstruction
- Arthroplasty
Background:
- Periacetabular osteotomy (PAO) is a hip preservation surgery.
- Some patients require total hip arthroplasty (THA) after PAO due to osteoarthritis.
- Evaluating THA outcomes post-PAO is crucial for optimizing patient care.
Purpose of the Study:
- To assess the clinical outcomes of total hip arthroplasty (THA) following periacetabular osteotomy (PAO).
- To identify factors linked to suboptimal acetabular component positioning and polyethylene wear after PAO.
- To provide insights for surgeons performing THA in patients with prior PAO.
Main Methods:
- A retrospective analysis of 34 patients (38 hips) who underwent THA after PAO.
- Computerized analysis of acetabular cup position (anteversion and abduction) and polyethylene wear rates.
- Clinical outcomes assessed using Harris hip, Oxford hip, and WOMAC scores at 4–10 years post-THA.
Main Results:
- No dislocations or revision surgeries were reported.
- Excellent median clinical scores: Harris hip 96, Oxford hip 38, WOMAC 78.
- Mean cup anteversion was 22°, mean abduction was 45°. Excessive abduction correlated with persistent hip dysplasia (CE <25°).
Conclusions:
- Total hip arthroplasty following periacetabular osteotomy can achieve excellent clinical results.
- Persistent acetabular dysplasia after PAO may predispose to excessive cup abduction during THA.
- Surgeons should be aware of this tendency and consider it during PAO surgery.
