The periacetabular osteotomy - Minimum 2 year followup in more than 100 hips

The results of 123 periacetabular osteotomies in 115 patients were reviewed at an average clinical followup of 4.3 years. The average age of the patie nts at the time of the operation was 32.9 years. The preoperative diagnosis was congenital dysplasia in 101 hips, Legg-Calve-Perthes disease in 10 hip s, Charcot Marie Tooth disease in four hips, epiphyseal dysplasia in three hips, congenital coxa vara in two hips, slipped capital femoral epiphysis i n one hip, and posttraumatic and postinfectious dysplasia in one hip each. The ilioinguinal approach was used in 67 hips and the modified Smith-Peters en approach was used in 56 hips. A periacetabular osteotomy was combined wi th an intertrochanteric osteotomy and/or trochanteric transfer in 32 hips. Ten hips underwent open reduction and internal fixation of an acetabular ri m fracture and 18 arthrotomies were performed at the time of periacetabular osteotomy. The average Harris hip score increased from 65 points preoperat ively to 89 points at latest followup. The average Merle d'Aubigne score in creased from 13.6 points preoperatively to 16.3 points at latest followup. Overall, 83% of the hips were rated clinically as good to excellent. Seven hips have undergone total hip arthroplasty and six subsequent intertrochant eric osteotomies were performed. The majority of the major complications oc curred when the osteotomy was performed through the ilioinguinal approach. The latest followup radiographic severity of osteoarthrosis, according to t he criteria of Tonnis, improved or was unchanged in 117 hips (95%), and pro gressed in only six hips (5%). The majority of the hips with preoperative c hanges in the periarticular bone showed some evidence of regeneration, whic h was shown by a decrease in the subchondral sclerosis, disappearance of cy sts, or healing of an acetabular rim fracture. The short term results of th e periacetabular osteotomy are encouraging from the standpoint of improveme nts in clinical scores and in the appearance of the joint.