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Large Joints Feature

X-ray of a Periacetabular Osteotomy surgery on right hip to correct shallow socket due to hip dysplasia in 29 year old female / Source: Wikimedia Commons and Hip2PAOFO

Periacetabular Osteotomy for Acetabular Dysplasia

Elizabeth Hofheinz, M.P.H., M.Ed. • Thu, February 22nd, 2018

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A team of researchers from Washington University School of Medicine, St. Louis has determined that given the right conditions, the Bernese periacetabular osteotomy (PAO) is an effective treatment for symptomatic acetabular dysplasia.

Their work, “Intermediate-Term Hip Survivorship and Patient-Reported Outcomes of Periacetabular Osteotomy: The Washington University Experience,” appears in the February 7, 2018 edition of The Journal of Bone and Joint Surgery.

Joel Wells, M.D., M.P.H. with the Department of Orthopaedic Surgery, University of Texas Southwestern Medical School in Dallas and co-author on the study, told OTW, “I am driven by the unique mechanics of the hip, and how there is no such thing as true idiopathic arthrosis of the hip. Hip preservation is an emerging field with great promise. This is the largest follow up of outcomes of the Bernese PAO.”

The authors wrote, “From July 1994 to August 2008, 238 hips (206 patients) were treated with PAO. Sixty-two had a diagnosis other than classic acetabular dysplasia, and 22 were lost to follow-up. The remaining 154 hips (129 patients) were evaluated at an average of 10.3 years postoperatively. Kaplan-Meier analysis was used to assess survivorship with an end point of total hip arthroplasty (THA). Hips were evaluated using the University of California at Los Angeles (UCLA) Activity Score, modified Harris hip score (mHHS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale score. A WOMAC pain subscale score of ≥10 and/or an mHHS of ≤70 were considered to indicate a clinically symptomatic hip.”

Dr. Wells commented to OTW, “The results prove that the Bernese PAO is an effective treatment for symptomatic acetabular dysplasia with very promising long-term results. It also brings to attention of a certain ‘sweet spot’ for acetabular correction, that has not been published before.”

“In an experienced PAO surgeon’s hands, the PAO is a powerful treatment for acetabular dysplasia and it is important to properly correct the deformity. With proper patient selection, surgical technique and recovery, the PAO has proven to be the treatment of choice for acetabular dysplasia.”

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