Favorable Early Outcomes and High Clinical Benefit Achievement Rate With Concomitant Hip Arthroscopy and Periacetabular Osteotomy for the Treatment of Developmental Dysplasia of the Hip.

Abstract

To report minimum 2-year follow-up patient-reported outcomes (PROs), clinical benefit, and survivorship in patients who underwent concomitant hip arthroscopy and periacetabular osteotomy (PAO) for the surgical treatment of the developmental dysplasia of the hip (DDH). Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy with concomitant PAO between December 2015 and September 2022. Patients with baseline and minimum 2-year PROs were included. Exclusion criteria included those who underwent an isolated PAO or had a history of ipsilateral prior surgery. The PROs collected were Hip Outcome Score-Activities of Daily Living (HOS-ADL) and Hip Outcome Score-Sport-Specific Subscale (HOS-SSS). The minimal clinically important difference (MCID) was reported. Survivorship was defined as nonconversion to total hip arthroplasty (THA). Thirty patients were included (29 females and 1 male). The average age at the time of surgery was 27.48 ± 8.57 years, and the average body mass index was 23.97 ± 4.05. Further, 86.67%, 73.33%, and 100% underwent labral treatment, femoroplasty, and capsular closure, respectively. The preoperative lateral center-edge angle increased from 17.07° ± 4.40 to 33.24° ± 3.40 postoperatively (P < .001). At a minimum of 2-year follow-up, all PROs significantly improved from baseline (P < .001): HOS-ADL improved from 62.68 ± 16.18 to 91.66 ± 15.13, HOS-SSS from 38.96 ± 21.39 to 86.82 ± 19.56. Moreover, 90% and 93.33% achieved MCID for the HOS-ADL and HOS-SSS, respectively. No conversions to THA were reported. At a minimum 2-year follow-up, the surgical management of DDH with PAO and concomitant hip arthroscopy demonstrated significant improvement in all PROs collected, with a high achievement rate for the MCID, and survivorship of 100%. These results suggest that, at short-term follow-up, this surgical approach seems to be safe and effective. Level IV, retrospective case-series.