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Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue 7, 883-888.
doi: 10.1302/0301-620X.91B7.22183  
Copyright © 2009 by British Editorial Society of Bone and Joint Surgery
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Comparison of periacetabular osteotomy and total hip replacement in the same patient

A TWO- TO TEN-YEAR FOLLOW-UP STUDY

P.-H. Hsieh, MD, Associate Professor1; K.-C. Huang, MD, Assistant Professor2; P.-C. Lee, MD, Assistant Professor1; and Y.-H. Chang, MD, PhD, Assistant Professor1

1 Department of Orthopaedics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 5, Fu-Hsing Street 333, Kweishian, Taoyuan, Taiwan.
2 Department of Orthopaedics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 6, West Sec, Chia-Pu Rd, Pu-Tz, Chia-Yi, 613, Taiwan.

Correspondence should be sent to Dr P.-H. Hsieh; e-mail: hsiehph{at}adm.cgmh.org.tw

We evaluated 31 patients with bilateral dysplastic hips who had undergone periacetabular osteotomy for early (Tönnis grade 0 or 1) or moderate (Tönnis grade 2) osteoarthritis in one hip and total hip replacement for advanced (Tönnis grade 3) osteoarthritis in the other. At a mean follow-up of 5.5 years (2 to 9) after periacetabular osteotomy and 6.7 years (3 to 10) after total hip replacement, there was no difference in the functional outcome in hips undergoing osteotomy for early or moderate osteoarthritis and those with a total hip replacement, as determined by the Merle d’Aubigné and Postel score and the Western Ontario and McMaster Universities osteoarthritis index. More patients preferred the spherical periacetabular osteotomy to total hip replacement (53% vs 23%; p = 0.029). Osteoarthritis secondary to hip dysplasia is often progressive. Given the results, timely correction of dysplasia by periacetabular osteotomy should be considered whenever possible in young patients since this could produce a favourable outcome which is comparable with that of total hip replacement.






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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General