Periacetabular osteotomy reduces the dynamic instability of dysplastic hips

Abstract

We compared the dynamic instability of 25 dysplastic hips in 25 patients using triaxial accelerometry before and one year after periacetabular osteotomy. We also evaluated the hips clinically using the Harris hip score and assessed acetabular orientation by radiography before surgery and after one year. The mean overall magnitude of acceleration was significantly reduced from 2.30 m/s 2 (SD 0.57) before operation to 1.55 m/s 2 (SD 0.31) afterwards. The mean Harris hip score improved from 78.08 (47 to 96) to 95.36 points (88 to 100). The radiographic parameters all showed significant improvements. This study suggests that periacetabular osteotomy provides pain relief, improves acetabular cover and reduces the dynamic instability in patients with dysplastic hips.

Treatment of Adolescents with a Periacetabular Osteotomy After Previous Pelvic Surgery

“…Previous reports have noted patients with hip dysplasia have increased flexion and reduced hip flexor moment [10,19,28,30]. Pedersen et al [27] initially reported this finding in a group of adult women with hip dysplasia after treatment with a PAO.…”

The Bernese periacetabular osteotomy for treatment of adult hip dysplasia

“…The mechanical goal of acetabular reorientation is to decrease articular surface contact stresses by increasing the contact area in affected hips [1,2,6]. Several investigators have created biomechanical models of dysplastic hips.…”

“…Recently, it was shown that the Bernese PAO improves hip mechanical stability by reducing hip acceleration during gait. Using triaxial accelerometry, it was shown that hip acceleration decreased from of 2.30 m/s 2 [2] in patients prior to surgery to 1.55 m/s 2 [2] 1 year after PAO surgery [6].…”

Acetabular and proximal femoral alignment in patients with osteoarthritis of the dysplastic hip and its influence on the progression of disease

“…Maeyama et al 32 reported that the femoral head moves upwards, backwards and laterally during walking, and that a peri-acetabular osteotomy in the dysplastic hip reduces the magnitude of acceleration of the femoral head in the upward and lateral directions. Our study supports this theory, suggesting that a peri-acetabular osteotomy improves the lateral containment function of the acetabulum by reducing the LII.…”