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Early postoperative complications following periacetabular osteotomy: a single-center cohort study on 1,356
Anne R Kristiansen1, Ole Ovesen2, Martin H Haubro2
1Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark, Denmark. annek17@student.sdu.dk.
Insights
Periacetabular osteotomy (PAO) has a 37% rate of minor complications and a 1.2% rate of major complications within 90 days. Extended hospital stays and readmissions occurred in 18% and 4.4% of cases, respectively.
Area of Science:
- Orthopedic surgery
- Surgical outcomes
- Patient safety
Background:
- Periacetabular osteotomy (PAO) is a significant orthopedic procedure.
- Limited data exists on early postoperative complications and hospitalizations following PAO.
Purpose of the Study:
- To report early postoperative complications (within 90 days) after PAO using the modified Clavien-Dindo classification.
- To analyze complications in patients with prolonged length of hospital stay (LOS) or 90-day readmissions.
Main Methods:
- Retrospective review of 1,356 PAO procedures performed between 2006 and 2021.
- Data collection included patient demographics, LOS, in-hospital complications, and 90-day readmissions.
- Complications were classified using the modified Clavien-Dindo system (grades 1-2 minor, grades 3-4 major).
Main Results:
- Minor complications occurred in 37% of PAO cases within 90 days; major complications were rare (1.2%).
- Length of hospital stay exceeded 4 days in 18% of patients, often associated with nausea and emesis.
- The 90-day readmission rate was 4.4%, primarily due to pain or wound infections requiring antibiotics.
Conclusions:
- PAO is associated with a substantial rate of minor complications but a low rate of major complications.
- A significant proportion of patients experienced prolonged hospital stays or required readmission within 90 days.
- These findings highlight key areas for optimizing perioperative care and patient management after PAO.
Background And Purpose:
Periacetabular osteotomy (PAO) is a major surgical procedure, yet data on early postoperative complications and hospitalizations remains limited. We aimed to report postoperative complications within 90 days using the modified Clavien-Dindo classification system. Our secondary aim was to report the peri- and postoperative complications observed in patients with length of hospital stay (LOS) exceeding 4 days or readmitted within 90 days following PAO.
Methods:
We identified patients who underwent PAO at a single institution between 2006 and 2021. Patient characteristics, LOS, in-hospital complications, and readmissions within 90 days postoperatively were obtained from our institutional database, patient files, and the Danish National Patient Registry to ensure complete follow up. Minor complications were defined as Clavien-Dindo grades 1 and 2, while major complications were defined as grades 3 and 4.
Results:
1,356 consecutive PAO procedures were performed in 1,096 patients with a mean age of 29.3 years (SD 11.1) and 77% females. Minor complications occurred in 499 hips (37%, 95% confidence interval [CI] 35-39) within 90 days of PAO. Only 16 (1.2%, CI 0.6-1.8) major complications were observed. LOS exceeded 4 days in 244 cases (18%) most frequently linked with nausea and emesis in 40 (2.9%). The 90-day readmission rate was 4.4% (CI 2.6-6.2), most commonly linked with pain in 11 (1.0%) and wound infection requiring antibiotics also in 11 (1.0%).
Conclusion:
PAO was associated with 37% minor complications within 90 days, while major complications were rare, occurring in only 1.2% of cases. After 18% of PAO procedures, LOS exceeded 4 days, and the 90-day readmission rate was 4.4%.
