Results of periacetabular osteotomy in adolescent and young adult hip dysplasia

Background Dysplasia of the hip is one of the most common causes of secondary osteoarthritis because of its associated structural instability. The Bernese periacetabular osteotomy (PAO) now is the preferred and the gold standard procedure for the treatment of symptomatic acetabular dysplasia. Objective The primary aim of our study was to evaluate the results of PAO in the treatment of adolescent and young adult patients with symptomatic hip dysplasia. Patients and methods This prospective case series’ study included 22 patients (26 hips, 13 left hips, 13 right hips) with hip dysplasia after surgical reorientation of the acetabulum by PAO procedure. This study included three male patients and 19 female patients. The mean age of our patients was 23 years (13–40 years). The mean follow-up period was 15 months (6–24 months). Twenty-one hips had undergone isolated PAO, while five hips had undergone combined surgery with the PAO at the same time (three hips had proximal femoral varus osteotomy and two hips had arthrotomy and osteochondroplasty). Results Twenty-five hips had good clinical and radiographic outcomes with respect to hip function and radiographic parameters. One patient developed avascular necrosis (AVN) of the femoral head 6 months after PAO and was treated by total hip replacement 1 year after PAO. The mean lateral central edge angle was 10.57°±11.61° preoperatively and was corrected to a mean value of 31.96°±4.42° with a mean correction of 21.38°. The mean postoperative acetabular index was 7.57°±1.81°, with a mean correction of 15.34°. In our series, the mean postoperative Harris hip score was 91.36±4.14, and the mean improvement was 29.08. Conclusion The PAO is an effective and valuable method for preservation of the natural hip joint and should be learned in a specialized center before using it in clinical practice.