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Long-Term Results of Periacetabular Rotational Osteotomy Concomitantly With Arthroscopy in Adult Acetabular Dysplasia
Institution:1. Department of Orthopaedic Surgery, Kyung Hee University School of Medicine, Seoul, Republic of Korea;2. Department of Orthopaedic Surgery, Kyung Hee University Hospital, Seoul, Republic of Korea;3. Center for Joint Diseases and Rheumatism, Kyung Hee University Hospital at Gangdong, Seoul, Republic of Korea;1. St. Joseph’s University Medical Center, Department of Orthopaedic Surgery, Paterson, New Jersey, U.S.A.;2. New Jersey Orthopaedic Institute, Wayne, New Jersey, U.S.A.;3. Hackensack Meridian School of Medicine at Seton Hall University, Department of Orthopaedic Surgery, Nutley, New Jersey, U.S.A.;3. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MI;1. Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MI;2. Department of Orthopaedic Surgery, Boston Children’s Hospital, Boston, MA
Abstract:BackgroundAlthough the long-term results of periacetabular osteotomy in acetabular dysplasia have been well documented, there is paucity in reports on the long-term outcomes of periacetabular osteotomy with simultaneous hip arthroscopy. This study aimed to assess the cumulative 10-year outcomes of periacetabular rotational osteotomy with concomitant hip arthroscopy.MethodsThrough an arthroscopic procedure, the status of the labrum was assessed, and torn labrum was debrided. Evaluations on survival from conversion to total hip arthroplasty and success in radiographic and clinical long-term results were completed in 39 hips (36 patients). Acetabular parameters (center-edge angle, Sharp angle, acetabular-head index, and head lateralization index), Tönnis grades on radiograph, Harris Hip Score, and range of motion of the hip were evaluated. Survivorship analyses were evaluated with the Kaplan-Meier method.ResultsThirty-eight hips (97.4%, 95% confidence interval 0.832-0.996) were preserved for 12.8 ± 1.7 years on average, and only 1 hip was converted to total hip arthroplasty at 7.8 years. All the acetabular parameters were improved (P < .001). Twenty-eight hips (71.8%) showed unchanged or improved Tönnis grades at the latest follow-up. The average Harris Hip Score was significantly better than the preoperative value (P < .001), and range of motion was not significantly different until the latest follow-up.ConclusionSufficient acetabular reorientation, such as periacetabular rotational osteotomy, with concomitant arthroscopic debridement showed successful long-term outcomes for acetabular dysplasia in adults.
Keywords:periacetabular rotational osteotomy  arthroscopy  long-term outcomes  labral tear  hip dysplasia
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