Does Previous Reconstructive Surgery Influence Functional Improvement and Deformity Correction After Periacetabular Osteotomy?

Polkowski, Gregory G.; Novais, Eduardo N.; Kim, Young-Jo; Millis, Michael B.; Schoenecker, Perry L.; Clohisy, John C.

doi:10.1007/s11999-011-2158-6

Cited by 30 publications

(20 citation statements)

References 28 publications

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“…Ön merkez açısındaki artış; 22 ile 26 derece arasında bildirilmiştir. [17][18][19] Tönnis ve ark. [5] ACE açısı için sınır değeri 25 derece olarak belirtmişlerdir.…”

Section: Discussionunclassified

A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

Konya

Tuhanioğlu

Aslan

et al. 2013

Eklem Hastalik Cerrahisi

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“…Ön merkez açısındaki artış; 22 ile 26 derece arasında bildirilmiştir. [17][18][19] Tönnis ve ark. [5] ACE açısı için sınır değeri 25 derece olarak belirtmişlerdir.…”

Section: Discussionunclassified

A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

Konya

Tuhanioğlu

Aslan

et al. 2013

Eklem Hastalik Cerrahisi

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“…Two patients had generally low HOOS scores but neither had bone cysts. Different patient-reported outcome scores are used to describe the mid-to long-term clinical outcomes after PAO and therefore are not directly comparable to the HOOS scores applied in our study, but our scores are in a similar range of acceptable scores for pain, function, and quality of life as reported by others [1,13,22,23]. Ten years after PAO, approximately 25% of the patients having a PAO will have substantial hip pain and/or undergo an arthroplasty.…”

Section: Discussionmentioning

confidence: 70%

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Mechlenburg

Nyengaard

Gelineck

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Periacetabular osteotomy (PAO) may affect cartilage thickness and cyst volume in patients with hip dysplasia. However, as no studies randomizing patients to either PAO or conservative treatment have been performed, to our knowledge, it is unknown if PAO directly affects the development or progression of osteoarthritis in patients with hip dysplasia. Questions/purposes We investigated (1) changes of cartilage thickness in the hip after PAO; (2) how many patients had subchondral bone cysts in the acetabulum or femoral head; (3) changes in cyst volume; and (4) patients' hip function and pain after PAO. Patients and Methods In this prospective study, 26 patients (22 women and four men) with hip dysplasia were enrolled with the goal of having MRI of the hip before undergoing PAO and again at 1, 2 1 .2, and 10 years after PAO. Of the 26 patients, 17 (65%) underwent complete followup 10 years after PAO, whereas nine could not be included. Of those nine, three had undergone THA, three had substantial hip symptoms, and three were lost to followup. Thickness of acetabular and femoral cartilage and volume of subchondral bone cysts were estimated in the remaining 17 patients. Ten years postoperatively, the patients' Hip disability and Osteoarthritis Outcome Scores (HOOS) were collected. Results Preoperatively, the mean thickness of the acetabular cartilage was 1.38 ± 0.14 mm compared with 1.43 ± 0.07 mm 10 years postoperatively (p = 0.73). The mean thickness of the femoral cartilage preoperatively was 1.37 ± 0.20 mm compared with 1.30 ± 0.07 mm 10 years postoperatively (p = 0.24). Seven patients had an increase in cyst volume, six had a decrease, and four had no cysts to start with and remained without cysts. Preoperatively, the median total cyst volume per patient was 6.0 cm 3 (range, 1.6-188.3 cm 3 ) compared with 2.9 cm 3 (range, 0.7-8.2 cm 3 ) (p = 0.18) at 10 years followup. At 10 years, the mean subscores for the HOOS were: pain, 79 ± 16;

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“…With revision PAOs, the mean correction attained was 19°for LCEA (p \ 0.001, SD 10°; 95% CI, 14-24), 13°for ACEA (p = 0.014, SD 12°; 95% CI, [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and À12°for AI (p \ 0.001, SD 9°; 95% CI, À20 to À15) ( Table 3). In comparison, the mean correction attained in the primary cohort was 22°in LCEA (p \ 0.001, SD 10°; 95% CI, 20-26), À17°for AI (p \ 0.001, SD 6°; 95% CI, À16 to À6), and 24°for ACEA (p \ 0.001, SD 12°; 95% CI, [19][20][21][22][23][24][25][26][27][28][29]. The mean correction in AI was less dramatic when directly comparing the revision and comparison groups (À12°to À17°, p \ 0.001, SD 2.3-8.5).…”

Section: Methodsmentioning

confidence: 93%

“…The outcomes of the PAO surgery after prior pelvis and/ or femoral osteotomy or arthroscopic procedures have been reported in small case series [8,10,12,25]. When considering only prior pelvic reconstruction, even less information exists to demonstrate the efficacy of the PAO.…”

Section: Introductionmentioning

confidence: 99%

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Stambough

Clohisy

Baca

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background As the Bernese periacetabular osteotomy (PAO) has grown in popularity, specific indications and the results in patients treated for those indications need to be evaluated. Currently, although many patients undergo PAO after having had prior pelvic osteotomy, there is limited information regarding the efficacy of the PAO in these patients.Questions/purposes The purpose of this study was to compare the (1) early pain, function, activity, and quality of life outcomes; (2) radiographic correction; and (3) major complications and failures between patients who underwent PAO after prior pelvic reconstruction versus those who had a PAO without prior surgery. Methods Between February 2008 and January 2012, 39 patients underwent PAO after prior pelvic osteotomy at one of 11 centers and were entered into a collaborative multicenter database. Of those, 34 (87%) were available for followup at a mean of 2.5 years (range 1-5 years). This group was compared with a matched group of 78 subjects, of whom 71 (91%) were available for followup at a similar interval. We compared clinical outcomes including UCLA activity score, SF-12, and Hip Disability and Osteoarthritis Outcome Score (HOOS); radiographic measures-anterior and lateral center-edge angle and acetabular inclination (AI)-and reoperations, major complications, and conversions to total hip arthroplasty. CI,) than the primary cohort. The revision cohort achieved a smaller average radiographic correction than in patients undergoing PAO without prior pelvic surgery. The mean correction in AI was less dramatic when directly comparing the revision and comparison groups (À12°to À17°, p\ 0.001, SD 2.3-8.5). Although there was no difference in severe complications requiring further surgery, there were two conversions to hip arthroplasty (p = 0.109; 95% CI, 0.004-2.042) in the study group. Conclusions PAO performed after prior pelvic surgery is associated with improvements in pain, function, radiographic correction, and early complication rates, but the improvements observed at short-term followup were smaller and more variable than those seen in patients who had not undergone prior pelvic surgery. We recommend considering PAO for residual deformities after prior osteotomy to improve function and quality life but warning patients of potential ceiling effects with a second periacetabular surgery. Level of Evidence Level III, therapeutic study.

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Does Previous Reconstructive Surgery Influence Functional Improvement and Deformity Correction After Periacetabular Osteotomy?

Cited by 30 publications

References 28 publications

A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

A comparison of short-term clinical and radiological results of Tönnis and Steel pelvic osteotomies in patients with acetabular dysplasia

Cartilage Thickness and Cyst Volume Are Unchanged 10 Years After Periacetabular Osteotomy in Patients Without Hip Symptoms

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

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