Clinical and radiological evaluation of the results of periacetabular osteotomy operation in adult patients with acetabular dysplasia

Acetabular dysplasia is a multi-plane deformity of the acetabulum, characterized by marked incompetence in the anterior and lateral of the femoral head, increased acetabular inclination, and lateral shift of the hip joint center. Adult acetabular dysplasia is a hip disorder that can progress to degenerative joint disease in young adults and, if left untreated, can result in secondary osteoarthritis in 50% of the patients up to age 50. Periacetabular osteotomy operations are performed to correct the incompatibility of the acetabulum with the femoral head. Osteoarthritis development can be prevented in patients with periacetabular osteotomy surgeries. The purpose of our study was; to evaluate the postoperative clinical and radiological results of the patients who treated with periacetabular osteotomy and to investigate its effect on clinical and functional status and quality of life.A total of 41 patients who treated with periacetabular osteotomy for acetabular dysplasia in Manisa Celal Bayar University Faculty of Medicine Orthopedics and Traumatology Clinic between January 2008 - August 2020 were included in the study. The Statistical Package for Social Sciences (SPSS for Windows, Version 21.0) was used for statistical analyses. Nominal variables were analyzed with Pearson's Chi-Square test, p <0.001 was considered statistically significant.The mean follow-up time was 5.17 years. At the last follow-up, flexion, abduction, adduction, internal rotation, and external rotation values were statistically significantly increased compared to the preoperative values (p <0.001). There was no statistically significant difference in the extension values compared to the preoperative period (p = 0.118). LCE, ACE, Acetabular Arc values, Anterior Coverage Percentage, Posterior Coverage Percentage, Craniocaudal Coverage Percentage and Acetabular Depth-To-Width Ratio measured were statistically significantly increased compared to the preoperative values (p <0.001). The Heading Index, Acetabular Index and Sharp Angle values were significantly decreased compared to the preoperative values (p <0.001). There was no statistically significant difference between Global Offset, Center Gap X and Center Gap Y values and preoperative values. A statistically significant improvement was obtained in the continuity of the S-M Line postoperatively (p = 0.002), and Anterior Impingement was significantly reduced (p <0.001). The numerical change of Posterior Impingement was not statistically significant. HHS, HOOS, SF-12 PS and SF-12 MS values measured at the last follow-up were statistically significantly increased compared to the preoperative values (p <0.001). Osteotomy is technically demanding, but offers reproducible results with preserved cartilage and good long-term survival in carefully selected patients suitable for rehabilitation. Pelvic osteotomy should be considered as a preferred alternative to arthroplasty in a young, active patient with correctable structural deformity of the hip.