title: Patient-Reported Outcomes of Periacetabular Osteotomy from the Prospective ANCHOR Cohort Study.
abstract: BACKGROUND
  Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery.
  
  
  METHODS
  A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79% of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes.
  
  
  RESULTS
  Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8%) of the hips underwent early conversion to total hip arthroplasty, 12 (3%) required reoperation, and 26 (7%) experienced a major complication.
  
  
  CONCLUSIONS
  This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making.
  
  
  METHODS
  Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
authors.affiliation: 1Departments of Orthopaedic Surgery (J.C.C. and G.B.) and Biostatistics (J.B.), Washington University School of Medicine, St. Louis, Missouri 2Illinois Bone & Joint Institute, Chicago, Illinois 3Ottawa General Hospital, Ottawa, Ontario, Canada 4Department of Orthopaedic Surgery, Boston Children's Hospital, Boston, Massachusetts 5Texas Scottish Rite Hospital, Dallas, Texas 6Shriners Hospitals for Children, St. Louis, Missouri 7Mayo Clinic, Rochester, Minnesota 8Hospital for Special Surgery, New York, NY 9Beaumont Hospital, Royal Oak, Michigan.
authors.forename: John C
authors.initials: JC
authors.lastname: Clohisy
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Ackerman
authors.forename: Geneva
authors.initials: G
authors.lastname: Baca
authors.forename: Jack
authors.initials: J
authors.lastname: Baty
authors.forename: Paul E
authors.initials: PE
authors.lastname: Beaulé
authors.forename: Young-Jo
authors.initials: YJ
authors.lastname: Kim
authors.forename: Michael B
authors.initials: MB
authors.lastname: Millis
authors.forename: David A
authors.initials: DA
authors.lastname: Podeszwa
authors.forename: Perry L
authors.initials: PL
authors.lastname: Schoenecker
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Sierra
authors.forename: Ernest L
authors.initials: EL
authors.lastname: Sink
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Sucato
authors.forename: Robert T
authors.initials: RT
authors.lastname: Trousdale
authors.forename: Ira
authors.initials: I
authors.lastname: Zaltz
mesh_terms: D000077:Acetabulum / Q000293:injuries / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006304:Health Status; D006617:Hip Dislocation / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010027:Osteotomy / Q000379:methods*; D000071066:Patient Reported Outcome Measures; D011183:Postoperative Complications / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D012086:Reoperation / Q000592:standards; D055815:Young Adult