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Improvements seen with PAO in patients with hip dysplasia, Down syndrome
Investigators found radiographic deformity improved and independent ambulation was preserved in patients with hip dysplasia and Down syndrome who underwent periacetabular osteotomy.
“Surgical treatment of hip dysplasia associated with Down syndrome is challenging,” Eduardo N. Novais, MD, told Healio.com/Orthopedics. “The results of our study are encouraging with most patients having the hips preserved at an average of 13 years after [periacetabular osteotomy] PAO.”
Researchers identified 19 patients (26 hips) with Down syndrome who underwent PAO at a mean age of 16.2 years. On average, the follow-up was 13.1 years. The modified Harris hip score and the Gross Motor Function Classification System were used to assess hip pain and function. The lateral and anterior center-edge angles, Tönnis angle, extrusion index, anterior and posterior wall indices and Tönnis grade of osteoarthritis were evaluated with preoperative and most recent radiographs.
Results showed 13 hips of 21 hips in the 19 patients with an HHS had good or excellent HHS results. Investigators noted 95% of patients were independent in ambulation. After PAO, all radiographic parameters improved significantly. Of the 26 hips, eight had failed the procedure. In an analysis comparing hips that failed with those that did not, factors that correlated with PAO failure included Tönnis grade-2 osteoarthritis and older patient age at the time of the procedure. – by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.