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Published on: September 7, 2022
Periacetabular osteotomy provides durable correction and low arthroplasty conversion at ≥ 7 years: prospective
Mahmoud Fahmy1, Ahmed Hazem Abdelazeem2, Mostafa Ahmed Shawky2
1Orthopaedic Department, Cairo University Kasr Alainy Faculty of Medicine, Cairo, Egypt. mahmoudfahmy1986@gmail.com.
Background:
Long-term prospective data on periacetabular osteotomy (PAO) from Middle Eastern populations are limited. This study evaluated ≥ seven year clinical, functional, and radiographic outcomes following PAO and identified predictors of survivorship.
Methods:
Thirty-six consecutive patients (34.6 ± 7.2 years; 78% female) undergoing PAO (2014-2018) were prospectively followed. Inclusion required symptomatic dysplasia with Tönnis 0-2. Outcomes included HHS, WOMAC, HOS, SF-36, radiographic parameters (LCEA, AI), complications, and THA conversion. Reliability, multivariate regression, and Kaplan-Meier analyses were performed.
Results:
At 7.8 ± 1.2 years, HHS improved from 63.5 ± 11.2 to 89.6 ± 7.8 (p < 0.001). LCEA increased from 16.2 ± 4.3° to 31.8 ± 3.9° and AI decreased from 22.8 ± 5.1° to 7.2 ± 3.6°. ICC for measurements was 0.92. Complications occurred in 16.7% (mostly minor). THA conversion was 5.6%, both with preoperative Tönnis 2 and correction < 12°. Magnitude of LCEA correction independently predicted HHS improvement (β = 0.41, p < 0.01).
Conclusions:
PAO achieved durable correction and sustained functional improvement with low THA conversion at mid- to long-term follow-up. Preoperative cartilage status and adequacy of correction are key determinants of outcome.
