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Complications, Conversion, and Secondary Procedures Following Minimally Invasive Periacetabular Osteotomy: A
Mohammad H Amer1,2, Yash Pursun3, Christian Smith4
1Orthopaedic Department, Northumbria Healthcare NHS Foundation Trust, Northumbria House, Cobalt Business Park, Newcastle Upon Tyne, UK.
Arthroplasty Today
|July 21, 2025
Summary
Minimally invasive periacetabular osteotomy (PAO) shows good mid-term results. Patient factors like higher BMI, smoking, and older age increase complication risks, guiding better patient selection and care.
Area of Science:
- Orthopedic surgery
- Hip joint biomechanics
- Surgical outcomes research
Background:
- Minimally invasive periacetabular osteotomy (PAO) has improved outcomes and expanded patient eligibility.
- Identifying patient-specific risk factors is crucial for optimizing PAO success.
Purpose of the Study:
- To identify patient-specific risk factors associated with poor outcomes after minimally invasive PAO.
- To evaluate complication rates and long-term hip survival following PAO.
Main Methods:
- Retrospective case series of 513 patients undergoing isolated PAO with minimum 1-year follow-up.
- Analysis of demographic and clinical data, including complication rates, secondary procedures, and conversion to total hip arthroplasty.
- Logistic regression and Kaplan-Meier analyses were used to determine risk factors and survival rates.
Main Results:
- Overall complication rate was 6.2%. Higher BMI, smoking, Tönnis grade 2, and increased age were significant risk factors for complications.
- Nonunion rate was 4.3%, with higher BMI and age correlating with increased risk.
- 10.9% required secondary procedures; 3.7% converted to total hip arthroplasty, with 10-year survival at 92.7%.
Conclusions:
- Minimally invasive PAO demonstrates acceptable mid-term complication and conversion rates.
- Patient factors including age, BMI, smoking, and Tönnis grade are linked to inferior outcomes.
- Understanding these risk factors aids in surgical decision-making, patient counseling, and perioperative management.
