title: Activity Tolerance After Periacetabular Osteotomy.
abstract: BACKGROUND
  Periacetabular osteotomy is a well-described surgical intervention for symptomatic acetabular deformities in skeletally mature patients. Data regarding return to athletic activity or sport after this procedure are still limited.
  
  
  OBJECTIVE
  To evaluate the ability of patients to return to preoperative levels of activity after periacetabular osteotomy.
  
  
  METHODS
  Case series; Level of evidence, 4.
  
  
  METHODS
  This is a retrospective review of active patients treated with periacetabular osteotomy for acetabular deformity correction. Patients were identified as those with preoperative University of California-Los Angeles activity levels ≥7. Patient demographics, operative data, radiographic measures, and clinical outcomes were documented prospectively. The University of California-Los Angeles activity score, Harris Hip Score, Hip Dysfunction and Osteoarthritis Outcome Score, and Western Ontario and McMaster Universities Osteoarthritis Index were used to measure clinical outcomes, and details regarding activity and satisfaction were analyzed.
  
  
  RESULTS
  This study included 36 patients (39 hips; 15 males and 21 females) whose average age was 25 years (range, 15-45 years) and whose average body mass index was 24 ± 3.5 kg/m(2). Mean follow-up was 33 months (range, 18-59 months). Preoperatively, the average lateral center edge angle, anterior center edge angle, and acetabular index were 10°, 14°, and 21°, respectively; 92% of patients had a Tönnis osteoarthritis grade of 0 or 1. One patient failed hip preservation surgery and went on to total hip arthroplasty 27 months after periacetabular osteotomy. Of the remaining patients, 71% reported an increase or no change in activity level postoperatively. The University of California-Los Angeles score was also unchanged (9.2 vs 8.8, P = .157), and the Harris Hip Score (63 vs 87, P < .001), Hip Dysfunction and Osteoarthritis Outcome Score-Quality of Life (38 vs 71, P < .001), and Western Ontario and McMaster Universities Osteoarthritis Index (71 vs 92, P < .001) results improved from preoperative levels. There was a 97% rate of satisfaction with the surgery. Four patients (11%) reported hip pain as the primary factor limiting postoperative activity.
  
  
  CONCLUSIONS
  The majority (71%) of active patients with hip dysplasia return to presurgical or higher activity levels after open hip preservation surgery with the periacetabular osteotomy.
authors.affiliation: Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA.
authors.forename: Ljiljana
authors.initials: L
authors.lastname: Bogunovic
authors.affiliation: Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA.
authors.forename: Devyani
authors.initials: D
authors.lastname: Hunt
authors.affiliation: Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA.
authors.forename: Heidi
authors.initials: H
authors.lastname: Prather
authors.affiliation: Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA.
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
authors.affiliation: Department of Orthopedic Surgery, Washington University, St Louis, Missouri, USA clohisyj@wudosis.wustl.edu.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
mesh_terms: D000077:Acetabulum / Q000000981:diagnostic imaging / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D019644:Arthroplasty, Replacement, Hip / Q000706:statistics & numerical data; D005260:Female; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000209:etiology; D010027:Osteotomy / Q000379:methods*; D011788:Quality of Life; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
keywords: acetabular dysplasia; hip dysplasia; periacetabular osteotomy; surgical hip dislocation