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PERIACETABULAR OSTEOTOMY: EXPERIENCE IN A NON-SUPERSPECIALIZED INSTITUTION



Abstract

Aims: A retrospective review of all periacetabular osteotomies (PAO) performed at a general elective orthopaedic Hospital over a 7-year period. To assess the clinical, functional and radiographic outcome associated with PAO when introduced as a new procedure to a non-super-specialised regional centre.

Methods: A retrospective review of 85 PAOs performed on 79 patients at Cappagh Hospital between 1/4/1998 and 1/4/2005. The medical records and radiographic images of all patients were reviewed. Clinical follow-up evaluations were also performed.

Results: 85 PAOs were performed on 79 patients. Mean age at time of surgery was 22.9 years (range, 14–41 years) with an increased preponderance of females (F:M=10:1) and right sided hip involvement (R:L=1.1:1). The mean Merle D’Aubigne and Postel hip score increased from 12.4 (range 9–14) preoperatively to 16 (range 11–18) postoperatively (P< 0.0001). The average lateral center edge angle increased from 5° preoperatively to 26° postoperatively (P< 0.0001). The anterior center edge angle averaged 6.6° preoperatively and improved to 34.4° postoperatively (P < 0.0001). The acetabular index angle decreased from an average of 24.8° preoperatively to 8.4° postoperatively (P< 0.0001). At clinical follow-up, 77% of patients had no/mild pain, 30% of patients had a limp and 64% of patients were unlimited in physical activity.

Conclusions: The short term results in this group of patients treated with PAO show reliable radiographic correction of deformity and improved clinical scores. We suggest that PAO may safely be carried out at a non-super-specialized institution provided the surgeons have sufficient experience and patients are selected appropriately.

Correspondence should be addressed to Ms Larissa Welti, Scientific Secretary, EFORT Central Office, Technoparkstrasse 1, CH-8005 Zürich, Switzerland