Outcomes of Hip Arthroscopy with Concomitant Periacetabular Osteotomy, Minimum Five-Year Follow-Up

Introduction: Bony correction of acetabular dysplasia is possible through rotational osteotomies. The Bernese periacetabular osteotomy (PAO) has proven to be an efficacious procedure yielding good long-term results. Concomitant hip arthroscopy may offer a complementary tool during PAO for treatment of acetabular dysplasia. We aim to report minimum five-year follow-up results of concomitant hip arthroscopy and PAO to treat acetabular dysplasia and intra-articular pathology.

Methods: Data were prospectively collected from October 2010 to June 2012. Patients were included in this study if they underwent concomitant hip arthroscopy and PAO and were eligible for minimum five-year follow-up. Follow-up was considered complete with documented modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score–Sports Subscale (HOS-SS), abbreviated International Hip Outcome Tool (iHOT-12), pain on a 0-10 visual analog scale (VAS), and patient satisfaction on a 0-10 scale. Significance was set at P=.05.

Results: Fourteen patients were eligible, thirteen of whom had complete follow-up at a minimum of five years after surgery. The average age of the patients was 21.9 years, and the average body mass index was 25. The mean lateral center-edge angle increased from 15.1ᵒ to 30.4ᵒ (P< .0001), and anterior center-edge angle increased from 11.3ᵒ to 28.9ᵒ (P< .0001). The Tӧnnis angle of acetabular inclination decreased from 18.9ᵒ to 4.9ᵒ (P< .0001). There were no arthritic changes seen in preoperative radiographs, and there was no progression of arthritis in radiographs taken at the latest clinical visit. All patient reported-outcomes scores demonstrated significant improvement from preoperative baseline to the minimum five-year follow-up scores (mHHS, P=.002; NAHS, P=.003; HOS-SS, P=.005). VAS decreased from a preoperative mean of 6.2 to 3.6 at latest follow-up (P=.004).

Conclusion: Concomitant hip arthroscopy and PAO appears to be a safe and effective procedure with favorable mid-term outcomes that are durable compared to the short-term.