Psychological Factors as Risk Contributors for Poor Hip Function after Periacetabular Osteotomy

Abstract

Psychologic comorbidities have been identified as risk factors for poor outcomes in orthopedic procedures, but their influence on the outcome of hip-preserving periacetabular osteotomy (PAO) remains uncertain. This retrospective cohort study aimed to assess the impact of patients’ psychological health on the outcome of PAO in patients with hip dysplasia (HD) and acetabular retroversion (AR). The study included 110 patients undergoing PAO for HD or AR between 2019 and 2021. Standardized questionnaires were administered to assess psychological factors, postoperative hip function, and activity level (mean follow-up: 25 months). Linear regression analyses were used to examine the associations between psychological factors and postoperative hip function and activity level. Both HD and AR patients showed improved postoperative hip function and activity levels. Linear regression analyses revealed that depression significantly impaired postoperative outcomes in both groups, whereas somatization negatively influenced the outcome in AR patients. General health perceptions significantly contributed to an improved postoperative outcome. These findings highlight the importance of concomitantly addressing psychologically relevant factors in order to improve patient outcomes after PAO procedures. Future prospective studies should continue to investigate the impact of various psychological factors and explore possibilities of incorporating psychological support into routine postoperative care for these patient cohorts.

Case Report: Hip arthroplasty after fracture-related joint infection caused by extensively drug-resistant Klebsiella pneumoniae

“…Besides intravenous antimicrobial treatment, the local application of antibiotic-loaded bone cement has been shown to be beneficial for infection control ( 28 , 29 ). In line with data by Morgenstern et al, who reported a significant reduction of infection rates due to local antibiotic application in open limb fractures, an antibiotic-loaded cemented filler was utilized to improve local antimicrobial therapy in our patient ( 30 ). Vancomycin, gentamicin and tobramycin are the most commonly added antibiotics in bone cement ( 31 ).…”