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Comparable outcome of periacetabular osteotomy in borderline and frank hip dysplasia: a cohort study
Quentin Karisch1, Justus Stamp1, Chiara Heller1
1Hannover Medical School, Department of Orthopedics, Anna-von-Borries-Straße 1-7, 30265 Hannover, Germany.
Purpose:
Periacetabular osteotomy (PAO) is increasingly considered a treatment option for symptomatic borderline hip dysplasia (BHD) with a lateral center-edge angle (LCEA) of 20°-25°. However, whether BHD hips are likely to benefit from PAO compared to truly dysplastic hips (LCEA <20°) remains unclear. The aim of this study was to compare the short-term outcome of PAO in borderline hip dysplasia with frank dysplasia.
Methods:
A prospective PAO database was utilized. A total of 230 hips with a minimum follow-up of 1 year that had undergone PAO by a single surgeon between January 2022 and December 2024 were included in this study. Patients were divided into BHD and frank dysplasia based on LCEA. The University of California and Los Angeles activity scale (UCLA), Hip Disability and Osteoarthritis Outcome Score - Physical Function Short Form, Western Ontario and McMaster Universities Osteoarthritis Index, international hip outcome tool-12, Harris Hip Score (HHS), modified HHS , German Forgotten Joint Score and Postel Merle d'Aubigné score were assessed at a mean follow-up of 17-21 months. Postoperative PROMs were compared between groups using unadjusted analyses and multivariable linear regression models adjusting for baseline PROMs, demographic factors, radiographic parameters, and concomitant procedures.
Results:
Most patient-reported outcome measures (PROMs) differed significantly preoperatively and were inferior in the BHD group. All PROMs improved significantly in both groups at follow-up. No statistically significant between-group differences were observed at final follow-up. In multivariable regression analyses, dysplasia severity was not associated with postoperative outcomes for any PROM. The improvement in UCLA was statistically significantly greater in the BHD group (p = 0.043).
Conclusion:
Patients with BHD benefit from PAO with a magnitude of improvement comparable to frank dysplasia. Severity of hip dysplasia was not an independent predictor of outcome, indicating comparable short-term clinical benefit between groups.
Level Of Evidence:
Level III.
