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A COMPARATIVE STUDY OF OUTCOME EVALUATION AFTER BERNESE PERIACETABULAR OSTEOTOMY



Abstract

Introduction and aims: Numerous questionnaires are available to assess outcome of hip arthroplasty, but as yet there is no consensus as to which are the most appropriate to use following acetabular osteotomy. We have prospectively evaluated a quality of life measure validated for patients from the United Kingdom and self-administered disease and hip specific questionnaires in patients undergoing Bernese periacetabular osteotomy and compared these to outcome as measured by the Harris hip and Merle d’Aubigne and Postel hip scores.

Method: Since 1997, 24 Bernese periacetabular osteotomies have been performed at our institution. Only patients with a primary diagnosis of development dysplasia of the acetabulum, no evidence of degenerative disease and a minimum of 24 months of follow-up were included in this study. Any non life-threatening co-morbid conditions were documented and recorded. Harris hip (HHS), Merle d’Aubigne and Postel (MDP), Nottingham Health Profile (NHP) and Oxford Hip scores (OHS) were calculated pre-operatively and post-operatively at 6 weeks, 12 weeks, 6 months, one year and then yearly.

Results: Patients have been followed up for an average of 3.2 years (range: 1–5.5 years). The male: female ratio was 1: 8.5. The average age at time of operation was 32.3 years (range 18 – 48). No patient required further surgery or conversion to total hip arthroplasty. Mean postoperative HHS was 89.9. MDP 16.4 and OHS 16.3. All dimensions of the NHP demonstrated improvement of greater than 50 %. The MDP and OHS were most sensitive to time of assessment in the post-operative period. There was no significant difference in the order of magnitude of improvement between any of the scores.

Conclusion: This study has demonstrated that the Bernese periacetabular osteotomy, in a carefully selected group of patients, has a reproducibly good outcome as measured by a variety of scoring methods dependent upon both clinician and patient derived assessment.

The abstracts were prepared by Mr Peter Kay, Editorial Secretary. Correspondence should be addressed to British Hip Society, The Hip Centre, Wrightington Hospital, Appley Bridge, Wigan, Lancashire WN6 9EP.