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Minimum 10-Year Outcomes of Total Hip Arthroplasty After Periacetabular Osteotomy
Hiroshi Asai1, Yusuke Osawa1, Yasuhiko Takegami1
1Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan.
Background:
Although total hip arthroplasty (THA) post-periacetabular osteotomy (PAO) has yielded excellent short-term and mid-term outcomes, long-term implant survivorship remains unclear. This study aimed to evaluate the long-term (minimum 10 year) outcomes of THA post-PAO and assist in determining surgical indications and planning for THA post-PAO.
Methods:
This study included 50 hips that underwent THA post-PAO, with a minimum follow-up of 10 years. Propensity score-matching based on age, sex, and Crowe type was used to establish the PAO and control groups. The mean age at the time of THA for the PAO and control groups was 56 (95.7% women) and 56 (91.7% women) years, respectively. There were 11 hips (22%) diagnosed with developmental dysplasia of the hip during childhood and treated conservatively. Key parameters assessed included the Harris Hip Score, complications, horizontal and vertical distances between the teardrop and femoral head center, radiolucent lines (RLLs), and loosening on radiographs. Subgroup analysis was performed to compare outcomes between the elevated and anatomical groups.
Results:
At the latest follow-up, the PAO group exhibited significantly lower Harris Hip Score than the control group (86.7 ± 9.4 versus 90.3 ± 5.7; P = 0.021). Radiographic analysis revealed RLLs in four (8.0%) and three (6.0%) cases in the PAO and control groups, respectively, without significant differences. Loosening cases were not observed in either group. Acetabular cups were located more superiorly in the PAO group than in the control group (26.1 ± 7.3 versus 22.8 ± 6.4; P = 0.020). Subgroup analysis indicated no significant difference in RLLs between the elevated and anatomical groups (5.5 versus 9.4%; P = 0.62).
Conclusions:
Although the functional outcomes of THA post-PAO were inferior to those of primary THA, implant survivorship was comparable between the two groups. In cases with large preoperative bone defects, the acetabular component was placed more superiorly in the PAO group, which did not appear to affect long-term (10 year) implant survivorship.
