title: Is cup positioning challenged in hips previously treated with periacetabular osteotomy?
abstract: After periacetabular osteotomy (PAO), some patients develop osteoarthritis with need of a total hip arthroplasty (THA). We evaluated the outcome of THA following PAO and explored factors associated with inferior cup position and increased polyethylene wear. Follow-up were performed 4 to 10 years after THA in 34 patients (38 hips) with previous PAO. Computer analysis evaluated cup position and wear rates. No patient had dislocations or revision surgery. Median scores were: Harris hip 96, Oxford hip 38 and WOMAC 78. Mean cup anteversion and abduction angles were 22° (range 7°-43°) and 45° (range 28°-65°). Outliers of cup abduction were associated with persisting dysplasia (CE <25°). THA after PAO can produce excellent clinical results. Persisting acetabular dysplasia following PAO may lead surgeons to place the acetabular component in excessive cup abduction, and this tendency should be recognized at the time of the PAO.
authors.affiliation: Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hartig-Andreasen
authors.affiliation: Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Maiken
authors.initials: M
authors.lastname: Stilling
authors.affiliation: Orthopaedic Research Unit, Aarhus University Hospital, Aarhus, Denmark; Department of Orthopaedics, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Kjeld
authors.initials: K
authors.lastname: Søballe
authors.affiliation: Department of Orthopaedics, Regionshospitalet Horsens, Horsens, Denmark.
authors.forename: Theis M
authors.initials: TM
authors.lastname: Thillemann
authors.affiliation: Department of Orthopaedics, Copenhagen University Hospital, Hvidovre, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
mesh_terms: D000077:Acetabulum / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000379:methods*; D019544:Equipment Failure Analysis; D005260:Female; D006618:Hip Dislocation, Congenital / Q000150:complications / Q000601:surgery*; D006622:Hip Prosthesis; D006801:Humans; D007873:Legg-Calve-Perthes Disease / Q000150:complications / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000009:adverse effects*; D011475:Prosthesis Failure; D055815:Young Adult
keywords: acetabular cup position; hip dysplasia; outcome scores; total hip arthroplasty