Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?
BACKGROUND
The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients.


OBJECTIVE
We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males.


METHODS
We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months).


RESULTS
We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively.


CONCLUSIONS
Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males.


METHODS
Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Ziebarth
K
K
Department of Orthopaedic Surgery, Universitätsklinik Inselspital, University of Berne, Berne, Switzerland.
Balakumar
J
J
Domayer
S
S
Kim
Y J
YJ
Millis
M B
MB
D000077:Acetabulum / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002114:Calcinosis / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D005269:Femur / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006621:Hip Joint / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult