Periacetabular osteotomy for hip dysplasia treatment through a mini-invasive technique. Our results at mid-term in 131 cases

Ramírez-Núñez, L.; Comas, Manuel R.; Cardenas, Carlomagno; Bellotti, Vittorio; Astarita, Emanuele; Chacón-Cascio, G.

doi:10.1016/j.recote.2020.03.010

Cited by 4 publications

(7 citation statements)

References 21 publications

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“… 56 , 57 The mean (SD) ages for patients in the included studies ranged from 17 years to 45 years. 58 , 59 26 studies were single cohort studies which assessed PROM preoperatively and postoperatively, 29 , 30 , 32 , 35 , 48 , 58 , 60 – 80 3 studies compared those having PAO as a first-time surgery with those who have had previous arthroscopy, 81 – 83 and 3 studies compared those having PAO with healthy controls. 19 , 84 , 85 …”

Section: Resultsmentioning

confidence: 99%

Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

O’Brien,

Semciw,

Mechlenburg

et al. 2023

HIP International

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Background: Hip dysplasia is a common condition in active adults with hip pain that can lead to joint degeneration. Periacetabular osteotomy (PAO) is a common surgical treatment for hip dysplasia. The effect of this surgery on pain, function and quality of life (QOL) has not been systematically analysed. Purpose: In adults with hip dysplasia: (1) evaluate differences in pain, function and QOL in those undergoing PAO and healthy controls; (2) evaluate pre- to post-PAO changes in pain, function and QOL; (3) evaluate differences in pain, function and QOL in those with mild versus severe dysplasia, undergoing PAO; and (4) evaluate differences in pain, function and QOL in those having primary PAO versus those with previous hip arthroscopy. Methods: A comprehensive, reproducible search strategy was performed on 5 different databases. We included studies that assessed pain, function and QOL in adults undergoing PAO for hip dysplasia, using hip-specific patient reported outcomes measures. Results: From 5017 titles and abstracts screened, 62 studies were included. Meta-analysis showed PAO patients had worse outcomes pre- and post-PAO compared to healthy participants. Specifically, pain (standardised mean difference [SMD] 95% confidence interval [CI]): −4.05; −4.78 to −3.32), function (−2.81; −3.89 to −1.74), and QOL (−4.10; −4.43 to −3.77) were significantly poorer preoperatively. Meta-analysis found patients experienced improvements following PAO. Pain improved from pre-surgery to 1-year (standardised paired difference [SPD] 1.35; 95% CI, 1.02–1.67) and 2 years postoperatively (1.35; 1.16–1.54). For function, the activities of daily living scores at 1 year (1.22; 1.09–1.35) and 2 years (1.06; 0.9–1.22) and QOL at 1 year (1.36; 1.22–1.5) and 2 years (1.3; 1.1–1.5) all improved. No difference was found between patients undergoing PAO with mild versus severe dysplasia. Conclusions: Before undergoing PAO surgery, adults with hip dysplasia have worse levels of pain, function and QOL compared to healthy participants. These levels improve following PAO, but do not reach the same level as their healthy participants. Registration: PROSPERO (CRD42020144748)

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Section: Resultsmentioning

confidence: 99%

Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

O’Brien,

Semciw,

Mechlenburg

et al. 2023

HIP International

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“…In the studies referenced above, hip-related pain, function and quality of life were measured using common hip-related questionnaires that have been shown to be reliable and valid in individuals with hip pathology, including (i) the modified Harris Hip Score or the standard Harris Hip Score (mHHS/HHS; n = 15) [ 3 , 7 , 29 , 31–33 , 35 , 36 , 38–41 , 43 , 44 , 47 ], (ii) the Hip Disability and Osteoarthritis Outcomes Score (HOOS; n = 10) [ 3 , 29 , 32 , 35 , 37 , 38 , 40 , 42 , 43 , 46 ], (iii) the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; n = 7) [ 33 , 35 , 38 , 39 , 44 , 46 , 47 ], (iv) the Copenhagen Hip and Groin Outcome Score (HAGOS; n = 3) [ 23 , 28 , 34 ], (v) the International Hip Outcome Tool (iHOT-12; n = 1) [ 32 ], (vi) the Patient-Reported Outcomes Measurement Information System (PROMIS; n = 1) [ 32 ], (vii) The Short Form 36 Health Survey Questionnaire (SF-36; n = 2) [ 33 , 42 ], (viii) the Numeric Pain Rating scale (NPRS; n = 1) [ 34 ], (ix) the Visual Analogue Scale (VAS; n = 1) [ 32 ], and the Non-Arthritic Hip Score (NAHS; n = 1) [ 45 ].…”

Section: Resultsmentioning

confidence: 99%

“…Of the overall included studies ( n = 23), 19 evaluated hip-related function in persons with symptomatic AD before and after PAO [ 3 , 7 , 31–45 , 47 , 48 ], using several PROs, including the mHHS/HHS ( n = 15) [ 3 , 7 , 29 , 31–33 , 35 , 36 , 38–41 , 43 , 44 , 47 ], HOOS ( n = 7) [ 3 , 29 , 32 , 35 , 37 , 38 , 42 ], WOMAC ( n = 4) [ 33 , 38 , 39 , 44 ], iHOT-12 and the PROMIS (physical function subscale; n = 1) [ 32 ], HAGOS ( n = 1) [ 34 ], and NAHS (1) [ 45 ]. Average scores on hip-related function before and after PAO in persons with symptomatic AD are provided in Table I .…”

Section: Resultsmentioning

confidence: 99%

“…To the best of our knowledge, this is the first review to synthesize evidence regarding patient-reported and mobility-related outcomes following PAO in persons with symptomatic AD as well as to reflect on future research for capturing real-world effects of PAO in this patient population. The current narrative review included 23 studies (9 prospective [ 3 , 7 , 23 , 28 , 31 , 32 , 33 , 34 , 35 ] and 14 retrospective [ 22 , 29 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 ]) that presented patient-reported and mobility-related outcomes in persons with symptomatic AD, both before and after PAO. Postoperatively following PAO, there were consistent improvements in PROs (pain, function, quality of life and self-reported PA).…”

Section: Discussionmentioning

confidence: 99%

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Mobility-related outcomes for periacetabular osteotomy in persons with acetabular dysplasia: setting the stage for measurement of real-world outcomes

Alrashdi

Motl

Aguiar

et al. 2021

Journal of Hip Preservation Surgery

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Periacetabular osteotomy (PAO) is a surgery for persons with symptomatic acetabular dysplasia (AD) that increases acetabular coverage of the femoral head for reducing hip pain and improving function. Patient-reported outcomes (PROs) are significantly improved following PAO, yet little is known regarding mobility-related outcomes. This narrative review provides a synthesis of evidence regarding PROs and mobility-related outcomes in persons with AD following PAO. We further identified important future research directions, chiefly the need for measurement of real-world outcomes. We searched PubMed using comprehensive predefined search terms. We included studies that (i) enrolled persons with AD undergoing PAO, (ii) included PROs and/or mobility-related outcomes and (iii) were written in English. We synthesized and summarized study characteristics and findings. Twenty-three studies were included in this review. Commonly evaluated PROs included pain (n = 14), hip function (n = 19) and quality of life (n = 9). Mobility-related outcomes included self-reported physical activity (PA; n = 11), walking speed and cadence (n = 4), device-measured PA (n = 2), and sit-to-stand, four-square-step and timed stair ascent tests (n = 1). Persons with AD had significant improvements in PROs following PAO, yet mobility-related outcomes (e.g. walking speed and device-measured PA levels) did not change over 1 year following PAO. Few studies have evaluated mobility-related outcomes following PAO, and these studies were of a low methodological quality. Future research might include experience sampling data collection approaches and body-worn devices as free-living, technology-driven methodologies to evaluate mobility and other outcomes in persons with AD undergoing PAO.

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“…Later modifications of the approach focused on less invasiveness to include omittance of the ASIS osteotomy, smaller incisions, and the minimally invasive subsartorial or trans-sartorial approach. These alterations from the first described Smith-Peterson approach reduced surgical trauma, operative time, blood loss, and hospitalization [16][17][18][19][20][21][22] . Considerations for choosing the surgical approach for the osteotomy should revolve around safety, efficacy, intraoperative visualization, and patient satisfaction.…”

Section: Discussionmentioning

confidence: 99%

Novel Utilization of Anterior Intrapelvic (Stoppa) Approach for Periacetabular Ganz Osteotomy

Klahs

Castagno

Tadlock

et al. 2021

JBJS Case Connector

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Case: The Ganz periacetabular osteotomy (PAO) is widely used to correct developmental hip dysplasia in the adolescent and young adult population. The aim of this case study was to examine the novel utility and safety of Stoppa approach for the Ganz PAO in a 15-year-old girl and 25-year-old man. The Stoppa approach is traditionally used for acetabular fractures, and its use for a Ganz PAO is relatively novel. Conclusion: The Stoppa approach allows surgeons to successfully perform the Ganz PAO while simultaneously providing direct visualization for all osteotomies and vital structures.

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Periacetabular osteotomy for hip dysplasia treatment through a mini-invasive technique. Our results at mid-term in 131 cases

Cited by 4 publications

References 21 publications

Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

Pain, function and quality of life are impaired in adults undergoing periacetabular osteotomy (PAO) for hip dysplasia: a systematic review and meta-analysis

Mobility-related outcomes for periacetabular osteotomy in persons with acetabular dysplasia: setting the stage for measurement of real-world outcomes

Novel Utilization of Anterior Intrapelvic (Stoppa) Approach for Periacetabular Ganz Osteotomy

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