title: Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia.
abstract: In order to clarify how intra-articular lesions influence the survival of a periacetabular osteotomy in patients with dysplasia of the hip, we performed an observational study of 121 patients (121 hips) who underwent a transposition osteotomy of the acetabulum combined with an arthroscopy. Their mean age was 40.2 years (13 to 64) and the mean follow-up was 9.9 years (2 to 18). Labral and cartilage degeneration tended to originate from the anterosuperior part of the acetabulum, followed by the femoral side. In all, eight hips (6.6%) had post-operative progression to Kellgren-Lawrence grade 4 changes, and these hips were associated with the following factors: moderate osteoarthritis, decreased width of the joint space, joint incongruity, and advanced intra-articular lesions (subchondral bone exposure in the cartilage and a full-thickness labral tear). Multivariate analysis indicated subchondral bone exposure on the femoral head as an independent risk factor for progression of osteoarthritis (p = 0.003). In hips with early stage osteoarthritis, femoral subchondral bone exposure was a risk factor for progression of the grade of osteoarthritis. Although the outcome of transposition osteotomy of the acetabulum was satisfactory, post-operative progression of osteoarthritis occurred at a high rate in hips with advanced intra-articular lesions, particularly in those where the degenerative process had reached the point of femoral subchondral bone exposure.
authors: Graduate School of Medical Sciences, Kyushu University, Department of Orthopaedic Surgery, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
authors: M
authors: M
authors: Fujii
authors: Y
authors: Y
authors: Nakashima
authors: Y
authors: Y
authors: Noguchi
authors: T
authors: T
authors: Yamamoto
authors: T
authors: T
authors: Mawatari
authors: G
authors: G
authors: Motomura
authors: Y
authors: Y
authors: Iwamoto
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005270:Femur Head / Q000473:pathology; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015207:Osteoarthritis, Hip / Q000000981:diagnostic imaging / Q000209:etiology / Q000517:prevention & control; D010027:Osteotomy / Q000379:methods*; D011379:Prognosis; D011859:Radiography; D016896:Treatment Outcome; D055815:Young Adult