FP6.13 Minimum 25 year followup of patients treated with Periacetabular Osteotomy: The Boston Experience

Background: Periacetabular osteotomy (PAO) is a non-arthroplasty treatment for symptomatic acetabular dysplasia (DDH). The literature regarding long-term patient outcomes after PAO remains limited. We report our evaluation of patients treated by PAO 25 to 33 years ago to identify factors associated with durable therapeutic success.

Materials and Methods: 141 patients with 173 dysplastic hips underwent PAO from 8/1/91 to 12/31/98 by a single surgeon. 6 patients died. 29 patients (31 hips) could not be located. 6 pts (12 hips) were contacted but did not yet return questionnaires. 124 hips in 100 patients were retrospectively evaluated at a minimum of 25 years/maximum of 33 years post-operatively. Hips were evaluated with use of the WOMAC Pain scale Western Ontario and McMaster Universities Osteoarthritis Index postoperatively. Osteotomy “failure” was defined as a pain score of >/=10 or the need for total hip arthroplasty.

Results: Of 124 hips in 100 patients analyzed from our cohort, 62 hips (50%) were minimally- or asymptomatic with a preserved hip. 53 hips in 48 patients) (43%%) had undergone hip replacement (THR). 9 hips (7%)) were symptomatic (WOMAC pain>10) with a preserved hip. Patients in the THR group were older than asymptomatic patients (54 ± 8 years vs. 50 ± 11 years; p=0.08). Most patients were female (83%). 89% of hip replacement patients were female.

Conclusions: Long-term follow-up of patients treated with PAO for symptomatic dysplasia suggests most at long-term follow-up report high levels of function, although 41% had required THR. Most who required THR also reported high levels of function.