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Long-term study finds Bernese periarticular osteotomy to be a safe, joint-conserving procedure

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SAN FRANCISCO — Researchers here reported that 9-year data on the use of Bernese periacetabular osteotomy indicate the procedure is valuable in the treatment of hip dysplasia.

"Hip dysplasia and concomitant arthrosis continue to be a difficult problem when treating the younger active patient with minimal symptoms," Travis Matheney, MD, of Boston, said. "Our analysis of 160 hips over 9 years indicates that the periacetabular osteotomy (PAO) [is] an effective joint-preserving technique in the majority of these patients treated for a painful hip dysplasia."

Matheney's comments came during the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons.

The study involved 160 hips in 135 patients, who received PAOs between May 1991 and September 1998 from a single surgeon. The average age at the time of surgery was 25.8 years.

The patients were evaluated using the WOMAC pain subscale and pre- and postoperative radiographs.

Overall, 140 of the hips were preserved at a mean of 9 years. The remaining went on to total hip arthroplasty, Matheney said.

The average WOMAC score in the surviving hips was 4 — good to excellent.

Complications seen included transient peroneal nerve palsy, nonunion of the pubic osteotomy and heterotrophic ossification, Matheney said.

Multiple logistical regression analyses identified three independent predictors of PAO failure: a patient older than 35 years, preoperative fair or poor joint congruency, and a minimum joint space width of less than 2 mm.

"It is our hope that the prediction algorithms presented here may be useful for guiding surgeon and patient in accurate decision making when considering PAO as a joint-preserving procedure," he said.

For more information:

• Matheney T, Kim YJ, Zurakowski D, et al. Long-term results following Bernese periacetabular osteotomy and predictors of clinical outcome. Paper #239. Presented at the 75th Annual Meeting of the American Academy of Orthopaedic Surgeons. March 5-9, 2008. San Francisco.