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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.
International Orthopaedics
|April 9, 2026
Summary
Periacetabular osteotomy (PAO) offers durable hip dysplasia correction and functional gains in Middle Eastern patients. Adequate correction and good preoperative cartilage predict successful long-term outcomes, with low rates of total hip arthroplasty conversion.
Area of Science:
- Orthopedic surgery
- Hip reconstruction
- Skeletal dysplasia management
Background:
- Limited long-term prospective data on periacetabular osteotomy (PAO) exists for Middle Eastern populations.
- This study addresses this gap by evaluating outcomes in this demographic.
Purpose of the Study:
- To assess mid- to long-term clinical, functional, and radiographic outcomes of PAO.
- To identify predictors of survivorship and success after PAO.
Main Methods:
- Prospective follow-up of 36 patients (34.6 ± 7.2 years) undergoing PAO for symptomatic hip dysplasia (Tönnis 0-2).
- Evaluation of Harris Hip Score (HHS), WOMAC, HOS, SF-36, and radiographic parameters (LCEA, AI).
- Analysis included reliability, multivariate regression, and Kaplan-Meier survival analyses.
Main Results:
- Significant improvement in HHS (63.5 to 89.6, p<0.001) at 7.8 years.
- Improved LCEA (16.2° to 31.8°) and reduced AI (22.8° to 7.2°).
- Complications in 16.7%; 5.6% THA conversion, associated with Tönnis 2 and correction <12°.
Conclusions:
- PAO provides durable correction and sustained functional improvement for hip dysplasia.
- Preoperative cartilage status and the magnitude of acetabular correction are critical for successful outcomes.
- Low rates of total hip arthroplasty (THA) conversion suggest PAO's effectiveness at mid- to long-term follow-up.
