Periacetabular osteotomy in patients fifty years of age or older.
BACKGROUND
Periacetabular osteotomy has been established as an effective treatment for early or mild osteoarthritis caused by developmental dysplasia of the hip. However, the optimal method of surgical reconstruction for older patients remains controversial. The purpose of this retrospective study was to evaluate the clinical and radiographic results of a curved periacetabular osteotomy for the treatment of developmental dysplasia of the hip in patients fifty years of age or older.


METHODS
We evaluated forty-six consecutive hips in forty-two patients fifty years of age or older (the older group) who had developmental dysplasia of the hip and had undergone a curved periacetabular osteotomy between 1995 and 2006 with a minimum two-year follow-up period. The mean age was 54.6 years. We compared the clinical and radiographic results of this cohort with those of fifty hips in forty-four patients who were less than fifty years old (the younger group) and were managed with the same osteotomy. The mean age was 32.3 years. The patients were matched according to sex and Tönnis grade. Radiographic measurements included the center-edge angle, acetabular roof obliquity, acetabular head index, anterior center-edge angle, and head lateralization index.


RESULTS
The mean Harris hip score improved from 69.6 points preoperatively to 90.9 points postoperatively in the older group and from 71.1 points preoperatively to 91.8 points postoperatively in the younger group. There were no significant differences in any of the radiographic measurements between the two groups preoperatively or postoperatively. The Tönnis grades improved in two hips and progressed in three hips in the older group and improved in three hips and progressed in three hips in the younger group.


CONCLUSIONS
Satisfactory results can be obtained clinically and radiographically after curved periacetabular osteotomy in patients fifty years of age or older with Tönnis grade-1 or 2 osteoarthritis of the hip secondary to developmental dysplasia.
Teratani
Takeshi
T
Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. md060015@cis.fukuoka-u.ac.jp
Naito
Masatoshi
M
Kiyama
Takahiko
T
Maeyama
Akira
A
D000077:Acetabulum / Q000601:surgery; D000328:Adult; D000367:Age Factors; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000209:etiology / Q000601:surgery*; D010027:Osteotomy / Q000379:methods*; D012189:Retrospective Studies; D055815:Young Adult