Survivorship of the Bernese Periacetabular Osteotomy: What Factors are Associated with Long-term Failure?

• DOI: 10.1007/s11999-016-4887-z
• Publication Date: 2016-05-13T10:12:44Z
• Authors: Joel Wells; Michael Millis; Young-Jo Kim; Evgeny Bulat; Patricia Miller; Travis Matheney
• Keywords: WOMAC; Sports medicine; Harris Hip Score

The Bernese periacetabular osteotomy (PAO) continues to be a commonly performed nonarthroplasty option treat symptomatic developmental hip dysplasia, but there are few long-term followup studies evaluating results after PAO.(1) What is the survivorship of PAO? (2) were validated outcomes scores among patients who had PAO more than 14 years ago? (3) factors associated with failure?One hundred fifty-eight dysplastic hips (133 patients) underwent between May 1991 and September 1998 by single surgeon. Of those, 37 (34 [26%]) lost followup; an additional seven (5% [eight hips]) not been seen in last 5 years. 121 (in 99 retrospectively evaluated at mean 18 (range, 14-22 years). Survivorship was assessed using Kaplan-Meier analysis total arthroplasty (THA) as endpoint. Hips for activity, pain, general health UCLA Activity Score, modified Harris score, WOMAC, Hip disability Osteoarthritis Outcome Score (HOOS). Failure defined WOMAC pain subscale score ≥ 10 or having undergone THA. divided into three groups: asymptomatic (did meet any failure criteria point time), (met previous most recent followup), replaced (having THA). A multinomial logistic regression model estimating equations approach used assess failure.Kaplan-Meier THA endpoint revealed survival rate (95% confidence interval [CI]) 74% (66%-83%) Twenty-six (21%) average 9 ± from surgery. Sixty-four (53%) remained did followup. Thirty-one (26%) considered failed based on SD 11 4 out 20 Although some initially their may have < 10. 16 that early (reported prior study), two followup, 17 years, four still because remaining eight Asymptomatic reported better Scores (asymptomatic: SD, 7 2; symptomatic: 6 2, p = 0.001), (pain, function, activity sections; asymptomatic: 80 11; 50 15, 2 4, HOOS 87 11, 52 20, 0.001) compared Age older 25 time (symptomatic: odds ratio [OR], 3.6; 95% CI, 1.3-9.8; 0.01; replaced: OR, 8.9; 2.6-30.9; preoperative joint space width ≤ mm (replaced: 0.3; 0.12-0.71; 0.007) 0.121; 0.03-0.56; while controlling poor fair congruency.This study demonstrates durability In subset patients, progression over time. Factors severe symptoms include age congruency, less mm. Future should focus groups we identified our study: those went followup.Level III, therapeutic study.