title: Risk factors for the need of hip arthroscopy following periacetabular osteotomy.
abstract: Despite the frequency of labral tears in symptomatic developmental dysplasia of the hip, no consensus exists regarding the treatment of coexisting dysplasia of the hip and tearing of the acetabular labrum. The purpose of this prospective, MR arthrography (MRA) based 2-year follow-up study was to identify risk factors predicting the need for a hip arthroscopy (HA) after periacetabular osteotomy (PAO). Ninety-nine patients (104 hips) scheduled for PAO were evaluated preoperatively and at 2-year follow-up. MRA was performed in all patients prior to PAO. At follow-up, patients were divided into a non-arthroscopy and arthroscopy group. The two groups were compared clinical and radiological, and risk factors for HA after PAO were calculated. Patient reported outcome measures (WOMAC, Oxford Hip and SF36) were filled out before PAO and at follow-up. Ninety-five hips (91.3%) were evaluated. Twenty-six hips (27%) required an arthroscopy within 2 years of the PAO. Risk factors were preoperative borderline dysplasia, acetabular retroversion and complete labral detachment. Labral tearing, degeneration or hypertrophy did not negatively affect the outcome of PAO. Patients not requiring an arthroscopy had a statistically significant better outcome measured by patients reported outcome measures. After PAO, 27% of the hips needed intra-articular assessment. Conventional radiographs and MRA analysis can be used to identify predictors for patients requiring HA after PAO. At 2-year follow-up, the clinical outcome improved in all patients. However, those patients who had no need of a HA after their PAO had superior results.
authors.affiliation: 1. Orthopaedic Research Unit, Aarhus University Hospital, Tage-Hansens Gade 2, Building 10A, DK-8000 Aarhus C, Denmark.
authors.forename: Charlotte
authors.initials: C
authors.lastname: Hartig-Andreasen
authors.affiliation: 2. Department of Orthopaedics, Clinical and Orthopeadic Research Hvidovre, Copenhagen University Hospital, Kettegård Allé 30, DK-2650 Hvidovre, Denmark.
authors.forename: Anders
authors.initials: A
authors.lastname: Troelsen
authors.affiliation: 3. Department of Orthopaedics, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark and.
authors.forename: Theis M
authors.initials: TM
authors.lastname: Thillemann
authors.affiliation: 4. Department of Radiology, Aarhus University Hospital, Nørrebrogade 44, DK-8000 Aarhus C, Denmark.
authors.forename: John
authors.initials: J
authors.lastname: Gelineck
authors.affiliation: 3. Department of Orthopaedics, Aarhus University Hospital, Tage-Hansens Gade 2, DK-8000 Aarhus C, Denmark and.
authors.forename: Kjeld
authors.initials: K
authors.lastname: Søballe