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. 2008 Oct;32(5):611-7.
doi: 10.1007/s00264-007-0372-3. Epub 2007 Jun 20.

Complications and patient satisfaction after periacetabular pelvic osteotomy

R Biedermann  1 , L Donnan, A Gabriel, R Wachter, M Krismer, H Behensky
Affiliations

Complications and patient satisfaction after periacetabular pelvic osteotomy

R Biedermann et al. Int Orthop. 2008 Oct.

Abstract
in English, French

Periacetabular osteotomy (PAO) is a well established method to treat hip dysplasia in the adult. There is, however, a lack of information on the subjective outcome of patients with complications after PAO. The purpose of this study was therefore to assess the influence of complications on the patients' post-operative wellbeing and function: 60 PAOs on 50 patients were investigated retrospectively after a mean follow-up of 7.4 years. The patients' self-reported assessment of health and function was evaluated by the Medical Outcomes Short Form-36 (SF-36) and the Western Ontario and McMaster Universities (WOMAC) questionnaires at last follow-up. Forty healthy persons served as a control group. Of the 60 interventions 13 had no complications. Minor complications occurred in 25 (41%) and in 22 (37%) at least one major complication occurred. SF-36 summary measure was 76.4 for PAO patients and 90.3 for the control group. Mean WOMAC score was 25.1. Patients with major complications had a similar subjective outcome as patients with minor or without complications, but persistent dysaesthesia due to lateral femoral cutaneous nerve dysfunction led to a worse subjective function. Lesions of the lateral femoral cutaneous nerve have much greater influence on patients' self-assessed functional outcome after PAO than previously reported and greater attention has to be given to this supposedly minor complication.

L’ostéotomie péri acétabulaire (PAO) est aujourd’hui une méthode de traitement de la dysplasie de la hanche chez l’adulte néanmoins un certain nombre d’études montre qu’il existe des complications post-opératoires. Le but de ce travail est d’évaluer ces complications et la fonction des patients. 60 PAO chez 50 patients ont été ainsi analysées de façon rétrospectives après un recul moyen de 7.4 ans. Une dernière évaluation clinique et fonctionnelle a été réalisée selon les questionnaires SF-36 et WOMAC, 40 personnes non opérées servant de groupe contrôle. Sur 60 interventions, 13 n’ont pas entraînée de complication. Des complications mineures sont survenues chez 25 patients (41%) et au moins une complication majeure chez 22 patients (37%). Le score de WOMAC a été mesuré en moyenne à 25.1. Les patients ayant présenté des complications majeures et ceux ayant présenté des complications mineures ont le même résultat subjectif et la même analyse de leur intervention avec une fonction qu’ils considèrent objectivement comme mauvaise, les lésions du nerf fémoro-cutanées ont donc une grande influence sur le devenir fonctionnel de ces patients, il est nécessaire de faire très attention à sa préservation pour éviter ce type de complications lors de l’ostéotomie péri acétabulaire.

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Figures

Fig. 1
Fig. 1
Results of WOMAC measures of PAO patients with dysaesthesia due to dysfunction of the lateral cutaneous nerve, PAO patients without dysaesthesia in comparison to WOMAC measures of a random population, patients after PAO and THR in other centres as published in the literature
Fig. 2
Fig. 2
Failures (conversion to arthroplasty or arthrodesis—small circles and interrupted line) and radiological deteriorations in the present study and in the literature as cited in Table 1 (asterisks and continuous line). The number of failures is presented as a percentage of the initial group of patients. The number of deteriorations is presented as a percentage of the patients with radiological deteriorations and without failure at the time of follow-up. Linear regression is shown for failures (dotted line) and for deteriorations (continuous line)
See this image and copyright information in PMC

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