The association the patient-reported outcomes after periacetabular osteotomy with radiographic features: a short-term retrospective study

Fan, Yinuo; Liu, Weifeng; Wu, Yiping; Li, Ruoyu; Hong, Guoju; Li, Zhongfeng; Chen, Lixin; Fang, Hanjun; Zhou, Chi; He, Wei; Chen, Zhenqiu

doi:10.1186/s13018-021-02858-9

Cited by 9 publications

(9 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Whereas Holleyman et al reported a preoperative value of 30.0 for the iHOT-12, the patient population of Fan et al had a preoperative iHOT-12 value of 60.9, whereas our patient cohort presented 40.0. The literature reports an increase in iHOT-12 around 30 points for PAO in patients with DDH, as we found an increase of 31.0 points 32 , 33 . As an increase of 13 points was assessed as the minimal clinical important difference in iHOT-12 score by Nwachukwu et al both the control group as well as the LSTV group exceeded the threshold for minimal clinical difference 34 .…”

Section: Discussionsupporting

confidence: 67%

The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

Becker

Hipfl

Schömig

et al. 2023

Sci Rep

View full text Add to dashboard Cite

Lumbo-sacral transitional vertebrae (LSTV) are the most common congenital alteration of the lumbo-sacral junction and known to significantly influence pelvic anatomy. However, the influence of LSTV on dysplasia of the hip (DDH) and the surgical treatment by periacetabular osteotomy (PAO) remains unknown. We retrospectively examined standardized standing anterior–posterior pelvic radiographs of 170 patients in 185 PAO procedures. Radiographs were examined for LSTV, lateral-central-edge-angle (LCEA), Tönnis-angle (TA), femoral-head-extrusion index (FHEI), and anterior-wall-index (AWI) and posterior-wall-index (PWI). Patients with LSTV were compared to an age- and sex-matched control group. Patient-reported outcome measurements (PROMs) were evaluated pre- and in the mean 63.0 months (range 47–81 months) postoperatively. 43 patients (25.3%) had LSTV. Patients with LSTV had significantly greater PWI (p = 0.025) compared to the matched control group. No significant differences were seen in AWI (p = 0.374), LCEA (p = 0.664), TA (p = 0.667), and FHEI (p = 0.886). Between the two groups, no significant differences were detected in pre- or postoperative PROMs. Due to the increased dorsal femoral head coverage in patients with LSTV and DDH compared to patients with sole DDH, a more pronounced ventral tilting might be performed in those patients with prominent posterior wall sign to avoid anterior undercoverage, which is a significant predictor for premature conversion to hip arthroplasty after PAO. However, anterior overcoverage or acetabular retroversion must be avoided due to the risk of femoroacetabular impingement. Patients with LSTV reported similar functional outcomes and activity after PAO as the control group. Therefore, even for patients with concomitant LSTV, which are frequent with one-fourth in our cohort, PAO is an efficient treatment option to improve clinical symptoms caused by DDH.

show abstract

Section: Discussionsupporting

confidence: 67%

The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

Becker

Hipfl

Schömig

et al. 2023

Sci Rep

View full text Add to dashboard Cite

show abstract

“…We included articles in which the PAO was performed in patients with no prior intervention for symptomatic hip dysplasia and in which both preoperative and postoperative patient-reported outcomes were reported. Articles that reported either the HHS, modified Harris Hip Score (mHHS), or WOMAC were included [8][9][10][11][12][13][14].…”

Section: Review Methodsmentioning

confidence: 99%

“…Patients with an oversized postoperative LCEA and poor or fair preoperative hip joint congruency were correlated with poor postoperative patient-reported outcomes via the HHS. A Tönnis angle of −10° to 0° was however determined to be a factor correlated with success, as evidenced by a satisfactory postoperative HHS [ 8 ].…”

Section: Reviewmentioning

confidence: 99%

Patient-Reported Outcomes and Factors Impacting Success of the Periacetabular Osteotomy

Akhtar¹,

Razick²,

Wen³

et al. 2023

Cureus

View full text Add to dashboard Cite

Hip dysplasia is a condition affecting both infants and adults, characterized by a shallow acetabulum that does not sufficiently cover the head of the femur. This leads to instability of the hip and elevated levels of mechanical stress around the acetabular rim. A popular procedure for the correction of hip dysplasia is the periacetabular osteotomy (PAO), in which fluoroscopically guided osteotomies around the pelvis are made to allow for repositioning of the acetabulum to fit properly on the femoral head. This systematic review aims to analyze patient factors that impact outcomes, as well as patient-reported outcomes such as the Harris Hip Score (HHS) and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). The patients in this review did not undergo any prior intervention for acetabular hip dysplasia, allowing for an unbiased reporting of outcomes from all included studies. Of studies reporting HHS, the mean preoperative HHS was 68.92 and the mean postoperative HHS was 89.1. Of the study that reported mHHS, the mean preoperative mHHS was 70, and the mean postoperative mHHS was 91. Of the studies reporting WOMAC, the mean preoperative WOMAC was 66, and the mean postoperative WOMAC was 63. Key findings of this review are that of the seven included studies, six achieved a minimally important clinical difference (MCID) based on patient-reported outcomes, and factors impacting outcome are preoperative Tönnis osteoarthritis (OA) grade, pre and postoperative lateral-center edge angle (LCEA), preoperative hip joint congruency, postoperative Tönnis angle, and age. In patients with no prior intervention for hip dysplasia, the PAO is a successful procedure with significant improvement in postoperative patient-reported outcomes. Despite the reported success of the PAO, proper patient selection is vital to avoid early conversions to total hip arthroplasty (THA) and prolonged pain. However, further investigation is prompted regarding the long-term survivorship of the PAO in patients with no prior intervention for hip dysplasia.

show abstract

“…Axial and anteroposterior plain radiographs of the pelvis were obtained preoperatively to identify the cam deformity and assess the Tönnis grade, the lateral centred edge angle (LCEA), and the alpha angle [30,31]. At admission, the following data were recorded: age, gender, duration of symptoms before surgery, side, and BMI (Kg/ m 2 ).…”

Section: Outcomes Of Interestmentioning

confidence: 99%

Midterm results after arthroscopic femoral neck osteoplasty combined with labral debridement for cam type femoroacetabular impingement in active adults

Migliorini

Maffulli

Bell³

et al. 2023

J Orthop Surg Res

View full text Add to dashboard Cite

Introduction Arthroscopic labral procedures are frequently undertaken in patients with femoroacetabular impingement (FAI). The role of arthroscopic femoral neck osteoplasty is well established, but less is known about labral procedures. This study evaluates the midterm efficacy and feasibility of arthroscopic osteoplasty with concomitant labral debridement for cam impingement in active adults. Methods The present study was conducted according to the STROBE Statement. All 108 patients who underwent primary hip arthroscopy for cam type FAI combined with labral debridement were considered. Axial and anteroposterior plain radiographs of the pelvis were obtained preoperatively to identify the cam deformity and assess the presence of osteoarthritis, the lateral centre-edge angle, and the alpha angle. The ROM (flexion, extension, abduction, adduction, and intra/extra rotation) was evaluated. The following PROMs were administered: visual analogic scale (VAS), Tegner Activity Scale, non-arthritic hip score (NAHS), the international Hip Outcome Tool (iHOT-33) overall score, and related subscales: symptoms and functional limitations, sports and recreational activities, job-related concerns, and social, emotional, and lifestyle concerns. Results At a mean of 2.0 ± 1.1 months, all 108 patients returned to their daily activities with no limitation. At a mean of 2.6 ± 1.4 months, all 108 patients were able to return to sport with no limitation. At 11.9 ± 2.1-month follow-up, no differences were reported in the range of motion compared to baseline: flexion (P = 0.3), extension (P = 0.09), abduction (P = 0.1), adduction (P = 0.3), internal rotation (P = 0.4), and external rotation (P = 0.6). At 72.8 ± 21.7-month follow-up, the mean VAS score was 1.7 ± 3.0, Tegner Activity Scale 3.5 ± 1.4, NAHS 92.1 ± 21.5, iHOT33 83.3 ± 27.2. At a mean of 21.7 ± 15.5 months following the index procedure, 14 of 108 patients had undergone total hip arthroplasty. No further revisions or complications were reported. Conclusion Arthroscopic femoral neck osteoplasty with concomitant labral debridement for cam type of FAI in active adults yields the reliable results, with a rate of progression to total hip arthroplasty of 13% (14 of 108) at 3-year follow-up. All patients returned to their daily activities with no limitation 2 months postoperatively. Within 3 months, all patients returned to sport with no limitations. No complication related to the index procedure was reported, and no further arthroscopic procedures were necessary.

show abstract

The association the patient-reported outcomes after periacetabular osteotomy with radiographic features: a short-term retrospective study

Cited by 9 publications

References 39 publications

The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

The influence of lumbo-sacral transitional vertebrae in developmental dysplasia of the hip: a matched pair analysis

Patient-Reported Outcomes and Factors Impacting Success of the Periacetabular Osteotomy

Midterm results after arthroscopic femoral neck osteoplasty combined with labral debridement for cam type femoroacetabular impingement in active adults

Contact Info

Product

Resources

About