Amer Mohammad H, Pursun Yash, Smith Christian, Sunil Kumar Karadi H, Malviya Ajay
Orthopaedic Department, Northumbria Healthcare NHS Foundation Trust, Northumbria House, Cobalt Business Park, Newcastle Upon Tyne, UK.
Cairo University, Al Kasr Al Aini, Cairo Governorate, Egypt.
Arthroplast Today. 2025 Jul 5;34:101766. doi: 10.1016/j.artd.2025.101766. eCollection 2025 Aug.
The introduction of minimally invasive periacetabular osteotomy (PAO) has reduced complications, allowing a broader range of patients to be considered for the procedure. This study aimed to identify patient-specific risk factors for poor outcomes.
This retrospective case series (n = 513) used data from a local hip registration registry. Isolated PAOs with at least 1-year follow-up were included. Electronic records were reviewed to extract demographics and variables. The primary outcome was complication rate, with secondary outcomes including secondary procedures and conversion to total hip arthroplasty. Logistic regression was performed to correlate independent variables to outcomes, and Kaplan-Meier analysis assessed the survival of the native hip and cumulative complication risk.
Complication rate was 6.2%. Higher body mass index (BMI), smoking, Tönnis grade 2, and increasing age were associated with higher odds of complications ( < .05). The nonunion rate was 4.3%; higher BMI and age linked to increased risk ( < .05). 10.9% of patients required a secondary procedure and cumulative risk for secondary procedures at 5 years was 11.4% and at 10 years was 17.2%. BMI correlated with the need for secondary procedures ( = .001). 3.7% (n = 19) required conversion to total hip arthroplasty with a mean time to conversion of 4.6 years ±2.04. The 5- and 10-year survival rates were 96.3 and 92.7%, respectively.
Minimally invasive PAO has acceptable rates of complication and conversion at mid-term follow-up. Age, BMI, smoking status, and Tönnis grade 2 are associated with inferior outcomes. Knowledge of patient-specific risk factors can help in decision-making, expectation setting, and perioperative interventions.
微创髋臼周围截骨术（PAO）的引入减少了并发症，使更多患者能够考虑接受该手术。本研究旨在确定导致预后不良的患者特异性风险因素。
本回顾性病例系列研究（n = 513）使用了当地髋关节登记处的数据。纳入至少随访1年的孤立性PAO病例。回顾电子记录以提取人口统计学和变量信息。主要结局是并发症发生率，次要结局包括二次手术和转为全髋关节置换术。进行逻辑回归以将自变量与结局相关联，Kaplan-Meier分析评估原生髋关节的生存率和累积并发症风险。
并发症发生率为6.2%。较高的体重指数（BMI）、吸烟、Tönnis 2级和年龄增加与并发症几率较高相关（P <.05）。不愈合率为4.3%；较高的BMI和年龄与风险增加相关（P <.05）。10.9%的患者需要二次手术，5年时二次手术的累积风险为11.4%，10年时为17.2%。BMI与二次手术的需求相关（P =.001）。3.7%（n = 19）的患者需要转为全髋关节置换术，平均转换时间为4.6年±2.04。5年和10年生存率分别为96.3%和92.7%。
在中期随访中，微创PAO的并发症和转换率可接受。年龄、BMI、吸烟状况和Tönnis 2级与较差的结局相关。了解患者特异性风险因素有助于决策、设定预期和围手术期干预。
