Factors leading to osteoarthritis after eccentric rotational acetabular osteotomy.
We performed eccentric rotational acetabular osteotomy consecutively in 273 hips in 248 patients with hip dysplasia. Twenty-one patients were male and 227 were female. The average age was 37.7 years at the time of the index operation. Twenty-two hips had no osteoarthritis, 129 had early osteoarthritis, 117 had advanced osteoarthritis, and five had end-stage osteoarthritis. Twenty-six hips also were treated with concomitant intertrochanteric valgus osteotomy. Patients were followed for a minimum of 5 years after surgery. The average Harris hip score improved from 71 points preoperatively to 92 points at the final followup. Nine hips were converted to total hip arthroplasty as a result of deterioration after surgery. Kaplan-Meier survivorship analysis 15 years after the index operation indicated 97% in pre- and early stages and 87% in advanced and end stages when the end point was total hip arthroplasty. Risk factors identified by multivariate analysis for development of osteoarthritis of the hip 5 years after the index operation were body mass index (24 kg/m2 or more), concomitant valgus osteotomy, operative year between 1989 and 1992, a postoperative center-edge angle of Wiberg less than 25 degrees , and a postoperative horizontal distance of the femoral head from the tear drop (40 mm or more).


METHODS
Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Hasegawa
Yukiharu
Y
Department of Orthopedic Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan. hassey@med.nagoya-u.ac.jp
Masui
Tetsuo
T
Yamaguchi
Jin
J
Kawabe
Kiyoharu
K
Suzuki
Sadao
S
D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D015992:Body Mass Index; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology*; D010027:Osteotomy; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index