Early experience and results with the periacetabular osteotomy - The Mayo clinic experience

The purpose of the present study was to review the early results of periace tabular osteotomy in the initial group of patients undergoing this procedur e at the authors' institution. The first 21 hips in 19 patients with greate r than 2 years followup, which represents the learning curve with this oper ation, were reviewed retrospectively, There were 14 females and five males with an average age of 21 years (range, 17-43 years). Intertrochanteric ost eotomy was performed simultaneously on four patients with coxa valga and in adequate correction with periacetabular osteotomy alone. At an average of 3 8 months of followup (range, 24-52 months), the Mayo hip scores improved fr om an average of 46 points (range, 34-58 points) to an average of 68 points (range, 42-80 points). Hip range of motion declined slightly in all three arcs of motion, The lateral center edge angle of Wiberg improved from an av erage of 2 degrees to an average of 24 degrees, The loading zone angle (Ton nis) improved from an average of 24 degrees to an average of 11 degrees. Th e anterior center edge angle of Lequesne improved from an average of -6 deg rees to an average of 38 degrees. Complications included two peroneal palsi es, both of which resolved completely; three ischial fractures that healed uneventfully; three asymptomatic pubic nonunions; and asymptomatic heteroto pic ossification in five patients. One patient underwent subsequent total h ip arthroplasty for progressive arthritis and pain. Another patient require d intertrochanteric osteotomy at a later date. The early results in this in itial group of patients treated with periacetabular osteotomy show reliable radiographic correction of deformity and improved function with an accepta ble complication rate. Patients should be counseled carefully about possibl e loss of motion postoperatively. Additional study is necessary to assess t he long term results of this procedure.