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Scientific Articles   |    
Periacetabular Osteotomy in Patients Fifty Years of Age or Older
Takeshi Teratani, MD1; Masatoshi Naito, MD1; Takahiko Kiyama, MD1; Akira Maeyama, MD1
1 Department of Orthopaedic Surgery, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka 814-0180, Japan. E-mail address for T. Teratani: md060015@cis.fukuoka-u.ac.jp
View Disclosures and Other Information
Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity.

A commentary by Christopher L. Peters, MD, is available at www.jbjs.org/commentary and as supplemental material to the online version of this article.
Investigation performed at the Department of Orthopaedic Surgery, Fukuoka University School of Medicine, Fukuoka, Japan

Copyright ©2010 American Society for Journal of Bone and Joint Surgery, Inc.
J Bone Joint Surg Am, 2010 Jan 01;92(1):31-41. doi: 10.2106/JBJS.H.01556
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Abstract

Background: 

Periacetabular osteotomy has been established as an effective treatment for early or mild osteoarthritis caused by developmental dysplasia of the hip. However, the optimal method of surgical reconstruction for older patients remains controversial. The purpose of this retrospective study was to evaluate the clinical and radiographic results of a curved periacetabular osteotomy for the treatment of developmental dysplasia of the hip in patients fifty years of age or older.

Methods: 

We evaluated forty-six consecutive hips in forty-two patients fifty years of age or older (the older group) who had developmental dysplasia of the hip and had undergone a curved periacetabular osteotomy between 1995 and 2006 with a minimum two-year follow-up period. The mean age was 54.6 years. We compared the clinical and radiographic results of this cohort with those of fifty hips in forty-four patients who were less than fifty years old (the younger group) and were managed with the same osteotomy. The mean age was 32.3 years. The patients were matched according to sex and Tönnis grade. Radiographic measurements included the center-edge angle, acetabular roof obliquity, acetabular head index, anterior center-edge angle, and head lateralization index.

Results: 

The mean Harris hip score improved from 69.6 points preoperatively to 90.9 points postoperatively in the older group and from 71.1 points preoperatively to 91.8 points postoperatively in the younger group. There were no significant differences in any of the radiographic measurements between the two groups preoperatively or postoperatively. The Tönnis grades improved in two hips and progressed in three hips in the older group and improved in three hips and progressed in three hips in the younger group.

Conclusions: 

Satisfactory results can be obtained clinically and radiographically after curved periacetabular osteotomy in patients fifty years of age or older with Tönnis grade-1 or 2 osteoarthritis of the hip secondary to developmental dysplasia.

Level of Evidence: 

Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.

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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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