Activity Level Maintenance at 10-Year Minimum Follow-up Among Active Patients Undergoing Periacetabular Osteotomy

Area of Science:

• Orthopedic surgery
• Hip preservation
• Activity-based outcomes

Background:

• Periacetabular osteotomy (PAO) is used to treat hip dysplasia, a condition causing pain and reduced activity.
• The University of California Los Angeles (UCLA) activity score measures patient activity levels before and after surgery.
• Understanding long-term activity maintenance post-PAO is crucial for active individuals.

Purpose of the Study:

• To evaluate long-term activity maintenance in patients who underwent PAO.
• To provide data for treatment decision-making and patient counseling.
• To assess the durability of PAO as a hip preservation technique.

Main Methods:

• Prospective longitudinal cohort study of patients undergoing PAO (2006-2013).
• Inclusion criteria: lateral center-edge angle <25°, UCLA score ≥7, minimum 10-year follow-up.
• Collected UCLA, modified Harris Hip Score, and WOMBAT scores.

Main Results:

• 61 hips analyzed at a mean 12.5-year follow-up; 79.4% did not require further surgery.
• 88.5% maintained high activity (UCLA ≥7) or had unrelated lower activity.
• Mean UCLA score decreased slightly (8.9 to 8.1, P=.009), but functional scores improved significantly (mHHS, WOMBAT pain).
• PAO before age 25 was associated with higher activity at follow-up (P=.030).

Conclusions:

• PAO is an effective hip preservation surgery for active patients with hip dysplasia.
• The procedure demonstrates durability, with most patients maintaining high activity levels at long-term follow-up (mean 12.5 years).
• PAO can help preserve the native hip and allow patients to maintain their desired activity levels.