Skip to main content

01.04.2015 | Symposium: 2014 Bernese Hip Symposium | Ausgabe 4/2015

Clinical Orthopaedics and Related Research® 4/2015

Does Previous Pelvic Osteotomy Compromise the Results of Periacetabular Osteotomy Surgery?

Clinical Orthopaedics and Related Research® > Ausgabe 4/2015
MD Jeffrey B. Stambough, MD John C. Clohisy, BA Geneva R. Baca, MD Ira Zaltz, MD Robert Trousdale, MD Michael Millis, MD, MS Daniel Sucato, MD, PhD Young-Jo Kim, MD Ernest Sink, MD Perry L. Schoenecker, MD Rafael Sierra, MD David Podeszwa, MD Paul Beaulé
Wichtige Hinweise
The institution of one or more of the authors (JCC) has received, during the study period, funding from The International Hip Dysplasia Institute, Curing Hip Disease Fund, and the ANCHOR Research Fund.
All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research ® editors and board members are on file with the publication and can be viewed on request.
Each author certifies that his or her institution approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.
This work was performed at the Department of Orthopaedic Surgery, Washington University of St Louis, St Louis, MO, USA.



As the Bernese periacetabular osteotomy (PAO) has grown in popularity, specific indications and the results in patients treated for those indications need to be evaluated. Currently, although many patients undergo PAO after having had prior pelvic osteotomy, there is limited information regarding the efficacy of the PAO in these patients.


The purpose of this study was to compare the (1) early pain, function, activity, and quality of life outcomes; (2) radiographic correction; and (3) major complications and failures between patients who underwent PAO after prior pelvic reconstruction versus those who had a PAO without prior surgery.


Between February 2008 and January 2012, 39 patients underwent PAO after prior pelvic osteotomy at one of 11 centers and were entered into a collaborative multicenter database. Of those, 34 (87%) were available for followup at a mean of 2.5 years (range 1–5 years). This group was compared with a matched group of 78 subjects, of whom 71 (91%) were available for followup at a similar interval. We compared clinical outcomes including UCLA activity score, SF-12, and Hip Disability and Osteoarthritis Outcome Score (HOOS); radiographic measures—anterior and lateral center-edge angle and acetabular inclination (AI)—and reoperations, major complications, and conversions to total hip arthroplasty.


Although both groups reached clinical improvement in all categorical measures, the revision PAO group demonstrated greater pain (HOOS pain, study 74 versus 85, p = 0.03; 95% confidence interval [CI], 18.58 to −0.95) and less function (HOOS activities of daily living, study 80 versus 92, p = 0.002; 95% CI, 018.99–4.45) than the primary cohort. The revision cohort achieved a smaller average radiographic correction than in patients undergoing PAO without prior pelvic surgery. The mean correction in AI was less dramatic when directly comparing the revision and comparison groups (−12° to −17°, p < 0.001, SD 2.3–8.5). Although there was no difference in severe complications requiring further surgery, there were two conversions to hip arthroplasty (p = 0.109; 95% CI, 0.004–2.042) in the study group.


PAO performed after prior pelvic surgery is associated with improvements in pain, function, radiographic correction, and early complication rates, but the improvements observed at short-term followup were smaller and more variable than those seen in patients who had not undergone prior pelvic surgery. We recommend considering PAO for residual deformities after prior osteotomy to improve function and quality life but warning patients of potential ceiling effects with a second periacetabular surgery.

Level of Evidence

Level III, therapeutic study.

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

e.Med Interdisziplinär

Mit e.Med Interdisziplinär erhalten Sie Zugang zu allen CME-Fortbildungen und Fachzeitschriften auf Zusätzlich können Sie eine Zeitschrift Ihrer Wahl in gedruckter Form beziehen – ohne Aufpreis.

Jetzt e.Med zum Sonderpreis bestellen!

Weitere Produktempfehlungen anzeigen
Über diesen Artikel

Weitere Artikel der Ausgabe 4/2015

Clinical Orthopaedics and Related Research® 4/2015 Zur Ausgabe
  1. Sie können e.Med Orthopädie & Unfallchirurgie 14 Tage kostenlos testen (keine Print-Zeitschrift enthalten). Der Test läuft automatisch und formlos aus. Es kann nur einmal getestet werden.


Neu im Fachgebiet Orthopädie und Unfallchirurgie

Mail Icon II Newsletter

Bestellen Sie unseren kostenlosen Newsletter Update Orthopädie und Unfallchirurgie und bleiben Sie gut informiert – ganz bequem per eMail.