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A minimally invasive periacetabular osteotomy improves the radiographic parameters and functional outcomes in the treatment of developmental dysplasia of the hip in adolescents and adults: surgical technique and early results

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Abstract

Purpose

To introduce West China Hospital periacetabular osteotomy (WCH PAO) for acetabular dysplasia in adolescent and young adult patients and evaluate the early clinical results of WCH PAO.

Methods

A retrospective analysis of 34 patients with developmental dysplasia of the hip was performed from October 2019 to April 2021. Baseline data with surgical time and perioperative blood-loss volume were retrieved from medical record systems. The lateral center-to-edge angle (LCEA), acetabular inclination (AI), hip disability and osteoarthritis outcome score (HOOS), University of California Los Angeles (UCLA), and modified Harris hip score (mHHS) were compared preoperatively and postoperatively.

Results

All patients had significant postoperative radiology improvements, including LCEA and AI. The LCEA was improved from 12.9 to 33.2°, and the AI was decreased from 27.2 to 8.5°. In addition, hip functional outcomes, including HOOS, UCLA and mHHS, were improved. The UCLA was improved from 3.9 to 6.3, and the HOOS was decreased from 71.0 to 10.5. The Harris hip score improved from 50.8 before surgery to 87.4 after surgery. The mean operative time was 155 min (range 120 to 190 min), and the mean intra-operative blood loss was 580.2 ± 285.5 ml. Furthermore, no major complications, including nerve injury or bone nonunion, occurred in the cohort study.

Conclusion

WCH PAO is a minimally invasive surgical method for acetabular dysplasia in adolescent and young adult patients who that simplifies the surgical procedure and decreases the incidence of complications related to osteotomy.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

WCH:

West China Hospital

DDH:

Developmental dysplasia of the hip

OA:

Osteoarthritis

PAO:

Periacetabulum osteotomy

LCEA:

Lateral center-to-edge angle

HOOS:

Hip Disability and Osteoarthritis Outcome Score

UCLA:

University of California Los Angeles

mHHS:

Modified Harris hip score

CT:

Computed tomography

AI:

Acetabular inclination

ERAS:

Enhanced recovery after surgery

TXA:

Tranexamic acid

TBL:

Total blood loss

PBV:

Patient’s blood volume

LFCN:

Lateral femoral cutaneous nerve

CAF:

Central acetabular fragment

IPC:

Ischial posterior column

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Funding

Science and Technology Program of Sichuan Science and Technology Department (2018SZ0145, 2018SZYZF0006).

Author information

Author notes

  1. Yunfeng Tang and Dong Wang contributed equally to this study

Authors and Affiliations

  1. Trauma Medical Center, Department of Orthopaedic Surgery, West China Hospital, West China Medical School, Sichuan University, No. 37 Guoxue Road, Chengdu, 610041, Sichuan Province, People’s Republic of China

    Yunfeng Tang, Dong Wang, Limin Wang, Wei Xiong, Qian Fang & Guanglin Wang

  2. West China Women’s and Children’s Hospital, No. 17 People’s South Road, Chengdu, Sichuan, China

    Wei Lin

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  1. Yunfeng Tang
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Contributions

YF-T analyzed the data and was a major contributor in writing the manuscript; D-W was a contributor in data analysis; LM-W, W-X, Q-F, and GL-W were contributors in writing the manuscript; W-L was responsible for reviewing and editing the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Wei Lin or Guanglin Wang.

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Ethics approval and consent to participate

The study was approved by the Ethical Committee of the West China Hospital, University of Sichuan. Written informed consent was obtained from all participants.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Tang, Y., Wang, D., Wang, L. et al. A minimally invasive periacetabular osteotomy improves the radiographic parameters and functional outcomes in the treatment of developmental dysplasia of the hip in adolescents and adults: surgical technique and early results. International Orthopaedics (SICOT) 46, 2807–2814 (2022). https://doi.org/10.1007/s00264-022-05545-4

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