Activity tolerance after Periacetabular osteotomy

Background: Periacetabular osteotomy is a well-described surgical intervention for symptomatic acetabular deformities in skeletally mature patients. Data regarding return to athletic activity or sport after this procedure are still limited.

Purpose: To evaluate the ability of patients to return to preoperative levels of activity after periacetabular osteotomy.

Study Design: Case series; Level of evidence, 4.

Methods: This is a retrospective review of active patients treated with periacetabular osteotomy for acetabular deformity correction. Patients were identified as those with preoperative University of California-Los Angeles activity levels ≥7. Patient demographics, operative data, radiographic measures, and clinical outcomes were documented prospectively. The University of California-Los Angeles activity score, Harris Hip Score, Hip Dysfunction and Osteoarthritis Outcome Score, and Western Ontario and McMaster Universities Osteoarthritis Index were used to measure clinical outcomes, and details regarding activity and satisfaction were analyzed.

Results: This study included 36 patients (39 hips; 15 males and 21 females) whose average age was 25 years (range, 15-45 years) and whose average body mass index was 24±3.5 kg/m². Mean follow-up was 33 months (range, 18-59 months). Preoperatively, the average lateral center edge angle, anterior center edge angle, and acetabular index were 10°, 14 deg;, and 21deg;, respectively; 92%of patients had a To nnis osteoarthritis grade of 0 or 1. One patient failed hip preservation surgery and went on to total hip arthroplasty 27 months after periacetabular osteotomy. Of the remaining patients, 71% reported an increase or no change in activity level postoperatively. The University of California-Los Angeles score was also unchanged (9.2 vs 8.8, P=.157), and the Harris Hip Score (63 vs 87, P<001), Hip Dysfunction and Osteoarthritis Outcome Score-Quality of Life (38 vs 71, P<001), and Western Ontario and McMaster Universities Osteoarthritis Index (71 vs 92, P<001) results improved from preoperative levels. There was a 97% rate of satisfaction with the surgery. Four patients (11%) reported hip pain as the primary factor limiting postoperative activity.

Conclusion: The majority (71%) of active patients with hip dysplasia return to presurgical or higher activity levels after open hip preservation surgery with the periacetabular osteotomy.