Patients undergoing minimally invasive periacetabular osteotomy demonstrate improved outcomes: a systematic review

Periacetabular osteotomy (PAO) has demonstrated favourable outcomes for the treatment of acetabular dysplasia. Minimally invasive (MI) PAO uses a smaller incision to preserve soft tissue, minimize complications, and accelerate recovery; however, the outcomes of MI PAO are still being established. The purpose of this study was to conduct a systematic review to assess the reoperation rates and patient-reported outcomes following MI PAO. A systematic review of the literature was conducted in PubMed, CENTRAL, and Scopus in April 2024 with the following keywords: (mini*) AND (periacetabular osteotomy"). The PRISMA criteria were used. Only studies that reported on patient-reported outcome measures (PROMs) of MI PAO techniques were included. Eight studies with study periods ranging between 2004 and 2021 including a total of 2247 hips were included in this review. Mean follow-up ranged from 12 to 60 months. The mean age at the time of surgery ranged from 20.0 to 38.7 years, and 85.6% of included hips were from female patients. Seven out of 8 included studies reported significant improvement in preoperative vs postoperative PROMs. The mean Non-Arthritic Hip Score ranged from 49.8 to 58.7 preoperatively compared to 77.2-89.4 postoperatively. Mean UCLA scores ranged from 3.9 to 4.67 preoperatively to 6.3-6.97 postoperatively. Mean Harris Hip Scores ranged from 50.8 to 66 preoperatively compared to 87.4-93 postoperatively. Conversion to THA rates ranged from 0% to 5.3% at a mean of 4.9 years (0.6-14). Patients undergoing MI PAO surgery for the treatment of acetabular dysplasia demonstrated low rates of conversion to THA and significant improvement in PROMs at short- to mid-term follow-up.