Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia

Abstract

In order to clarify how intra-articular lesions influence the survival of a periacetabular osteotomy in patients with dysplasia of the hip, we performed an observational study of 121 patients (121 hips) who underwent a transposition osteotomy of the acetabulum combined with an arthroscopy. Their mean age was 40.2 years (13 to 64) and the mean follow-up was 9.9 years (2 to 18). Labral and cartilage degeneration tended to originate from the anterosuperior part of the acetabulum, followed by the femoral side. In all, eight hips (6.6%) had post-operative progression to Kellgren-Lawrence grade 4 changes, and these hips were associated with the following factors: moderate osteoarthritis, decreased width of the joint space, joint incongruity, and advanced intra-articular lesions (subchondral bone exposure in the cartilage and a full-thickness labral tear). Multivariate analysis indicated subchondral bone exposure on the femoral head as an independent risk factor for progression of osteoarthritis (p = 0.003). In hips with early stage osteoarthritis, femoral subchondral bone exposure was a risk factor for progression of the grade of osteoarthritis. Although the outcome of transposition osteotomy of the acetabulum was satisfactory, post-operative progression of osteoarthritis occurred at a high rate in hips with advanced intra-articular lesions, particularly in those where the degenerative process had reached the point of femoral subchondral bone exposure.

Joint Space Predicts THA After Hip Arthroscopy in Patients 50 Years and Older

“…A few studies [7,23] have used the K-L grading system to evaluate hips. The K-L grading system has been widely used in the knee literature.…”

Postoperative Improvement of Femoroacetabular Impingement After Intertrochanteric Flexion Osteotomy for SCFE

“…Since Drehmann's sign [5] or limitation of hip flexion was seen before inducing pain during the maneuver of the hip impingement sign, Drehmann's sign and maximum angle of hip flexion were also evaluated. In addition, we evaluated early osteoarthritic changes on the most recent AP radiographs according to the Kellgren-Lawrence classification system [8,15].…”

Acetabular Tilt Correlates with Acetabular Version and Coverage in Hip Dysplasia

“…We reviewed pelvic CT scans from 84 patients (143 hips) with DDH, obtained during their preoperative examinations for a transposition osteotomy of the acetabulum [5] between July 2004 and February 2008. Hips with minimal or no osteoarthritic changes with a lateral center-edge angle of Wiberg (LCE) [38] less than 20°on AP pelvic radiographs were included in this study.…”