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Periacetabular osteotomy for acetabular retroversion: A systematic review and meta-analysis.
Si Heng Sharon Tan1, Joelle Hwee Inn Tan1, Andrew Kean Seng Lim1
1National University Hospital, 1E Kent Ridge Road, Singapore 119228, Singapore.
Orthopaedics & Traumatology, Surgery & Research : OTSR
|September 28, 2021
Summary
Anteverting periacetabular osteotomy (PAO) effectively corrects acetabular retroversion and hip dysplasia, showing sustained improvements in clinical outcomes for over 10 years. This procedure offers a favorable survival rate with manageable complication rates.
Area of Science:
- Orthopedic surgery
- Hip reconstruction
- Pelvic osteotomy
Background:
- Acetabular retroversion is a complex hip condition often requiring surgical intervention.
- Evidence for the efficacy of periacetabular osteotomy (PAO) in managing acetabular retroversion has been limited.
- Understanding the indications, outcomes, and survival rates of anteverting PAO is crucial for patient management.
Purpose of the Study:
- To systematically review the indications for anteverting PAO in acetabular retroversion.
- To evaluate the effectiveness of anteverting PAO in correcting acetabular retroversion and improving clinical outcomes.
- To determine the survival rates and complication profile of anteverting PAO for acetabular retroversion.
Main Methods:
- A systematic review and meta-analysis adhering to PRISMA guidelines.
- Searches of PubMed MEDLINE and CINAHL databases up to May 1, 2020.
- Inclusion of seven studies involving 225 hips reporting outcomes of PAO for acetabular retroversion.
Main Results:
- Significant correction of crossover and posterior wall signs was observed post-PAO.
- Improvements in LCEA and AI, functional outcomes, and range of motion were sustained up to 11 years.
- The mean survival time was over 10 years, with only 7.1% requiring subsequent surgery; low-grade and high-grade complication rates were 31.6% and 12.0%, respectively.
Conclusions:
- Anteverting PAO is indicated for symptomatic acetabular retroversion, effectively correcting the deformity and associated hip dysplasia.
- The procedure demonstrates positive and sustained clinical outcomes for over a decade, with a favorable survival estimate.
- Anteverting PAO offers a viable surgical option for acetabular retroversion with a predictable outcome and complication profile.
