Total hip arthroplasty after periacetabular osteotomy versus primary total hip arthroplasty: a propensity-matched cohort study

doi:10.1007/s00402-021-03817-z

. 2021 Aug;141(8):1411-1417.

doi: 10.1007/s00402-021-03817-z. Epub 2021 Feb 24.

Total hip arthroplasty after periacetabular osteotomy versus primary total hip arthroplasty: a propensity-matched cohort study

Keisuke Komiyama¹, Satoshi Hamai^{2

3}, Goro Motomura¹, Satoshi Ikemura¹, Masanori Fujii¹, Shinya Kawahara¹, Yasuharu Nakashima¹

Affiliations

¹ Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
² Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hamachan@ortho.med.kyushu-u.ac.jp.
³ Department of Medical-Engineering Collaboration for Healthy Longevity, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hamachan@ortho.med.kyushu-u.ac.jp.

PMID: 33625543
DOI: 10.1007/s00402-021-03817-z

Total hip arthroplasty after periacetabular osteotomy versus primary total hip arthroplasty: a propensity-matched cohort study

Keisuke Komiyama et al. Arch Orthop Trauma Surg. 2021 Aug.

. 2021 Aug;141(8):1411-1417.

doi: 10.1007/s00402-021-03817-z. Epub 2021 Feb 24.

Authors

Keisuke Komiyama¹, Satoshi Hamai^{2

3}, Goro Motomura¹, Satoshi Ikemura¹, Masanori Fujii¹, Shinya Kawahara¹, Yasuharu Nakashima¹

Affiliations

¹ Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan.
² Department of Orthopedic Surgery, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hamachan@ortho.med.kyushu-u.ac.jp.
³ Department of Medical-Engineering Collaboration for Healthy Longevity, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan. hamachan@ortho.med.kyushu-u.ac.jp.

PMID: 33625543
DOI: 10.1007/s00402-021-03817-z

Abstract

Background: Controversy still exist regarding the outcomes of total hip arthroplasty (THA) after periacetabular osteotomy (PAO). The purpose of this study was to compare the clinical and radiologic outcomes of THA after PAO with primary THA based on balanced baseline characteristics with propensity score matching.

Methods: Using propensity score matching, 1:2 matched cohort to facilitate comparison between patients who underwent primary cementless THA with or without previous PAO. Then, we compared the operative time, blood loss, complications, postoperative clinical score, cup size, position, and alignment of acetabular cup, and degree of bony coverage on cup between the two groups.

Results: Thirty-five patients with 37 hips who underwent THA after PAO were successfully matched to 70 patients with 74 hips who underwent primary THA. The operative time and blood loss in THA after PAO were significantly longer and larger than those in primary THA (P < 0.001 and = 0.0067, respectively). Clinical score showed no difference between the groups (P > 0.05). For THA after PAO, the cup size and bony coverage were larger (P = 0.0014 and < 0.001, respectively), and the hip center was significantly higher and laterally (P < 0.001 and < 0.001, respectively) comparing primary THA.

Conclusion: This study demonstrated longer operative time and larger blood loss without difference in the postoperative clinical score or complications between THA after PAO and primary THA. Furthermore, THA after PAO provided larger cup size and superolaterally positioned cup center without difference in the cup inclination or anteversion comparing primary THA.

Keywords: Clinical outcome; Periacetabular osteotomy; Propensity score matching; Radiologic outcome; Total hip arthroplasty.

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References

1. Fujii M, Nakashima Y, Noguchi Y, Yamamoto T, Mawatari T, Motomura G, Iwamoto Y (2011) Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia. J Bone Jt Surg Br 93(11):1449–1456. https://doi.org/10.1302/0301-620x.93b11.27314 - DOI
1. Osawa Y, Seki T, Takegami Y, Kusano T, Ishiguro N, Hasegawa Y (2019) Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty. Arch Orthop Trauma Surg 139(5):729–734. https://doi.org/10.1007/s00402-019-03174-y - DOI - PubMed
1. Roder C, Staub LP, Eggli S, Dietrich D, Busato A, Muller U (2007) Influence of preoperative functional status on outcome after total hip arthroplasty. J Bone Jt Surg Am 89(1):11–17. https://doi.org/10.2106/jbjs.e.00012 - DOI
1. Ito H, Takatori Y, Moro T, Oshima H, Oka H, Tanaka S (2015) Total hip arthroplasty after rotational acetabular osteotomy. J Arthroplasty 30(3):403–406. https://doi.org/10.1016/j.arth.2014.10.002 - DOI - PubMed
1. Fukui K, Kaneuji A, Sugimori T, Ichiseki T, Matsumoto T (2015) Does rotational acetabular osteotomy affect subsequent total hip arthroplasty? Arch Orthop Trauma Surg 135(3):407–415. https://doi.org/10.1007/s00402-015-2154-5 - DOI - PubMed

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[1] Fujii M, Nakashima Y, Noguchi Y, Yamamoto T, Mawatari T, Motomura G, Iwamoto Y (2011) Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia. J Bone Jt Surg Br 93(11):1449–1456. https://doi.org/10.1302/0301-620x.93b11.27314 - DOI

[2] Fujii M, Nakashima Y, Noguchi Y, Yamamoto T, Mawatari T, Motomura G, Iwamoto Y (2011) Effect of intra-articular lesions on the outcome of periacetabular osteotomy in patients with symptomatic hip dysplasia. J Bone Jt Surg Br 93(11):1449–1456. https://doi.org/10.1302/0301-620x.93b11.27314 - DOI

[3] Osawa Y, Seki T, Takegami Y, Kusano T, Ishiguro N, Hasegawa Y (2019) Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty. Arch Orthop Trauma Surg 139(5):729–734. https://doi.org/10.1007/s00402-019-03174-y - DOI - PubMed

[4] Osawa Y, Seki T, Takegami Y, Kusano T, Ishiguro N, Hasegawa Y (2019) Failed periacetabular osteotomy leads to acetabular defects during subsequent total hip arthroplasty. Arch Orthop Trauma Surg 139(5):729–734. https://doi.org/10.1007/s00402-019-03174-y - DOI - PubMed

[5] Roder C, Staub LP, Eggli S, Dietrich D, Busato A, Muller U (2007) Influence of preoperative functional status on outcome after total hip arthroplasty. J Bone Jt Surg Am 89(1):11–17. https://doi.org/10.2106/jbjs.e.00012 - DOI

[6] Roder C, Staub LP, Eggli S, Dietrich D, Busato A, Muller U (2007) Influence of preoperative functional status on outcome after total hip arthroplasty. J Bone Jt Surg Am 89(1):11–17. https://doi.org/10.2106/jbjs.e.00012 - DOI

[7] Ito H, Takatori Y, Moro T, Oshima H, Oka H, Tanaka S (2015) Total hip arthroplasty after rotational acetabular osteotomy. J Arthroplasty 30(3):403–406. https://doi.org/10.1016/j.arth.2014.10.002 - DOI - PubMed

[8] Ito H, Takatori Y, Moro T, Oshima H, Oka H, Tanaka S (2015) Total hip arthroplasty after rotational acetabular osteotomy. J Arthroplasty 30(3):403–406. https://doi.org/10.1016/j.arth.2014.10.002 - DOI - PubMed

[9] Fukui K, Kaneuji A, Sugimori T, Ichiseki T, Matsumoto T (2015) Does rotational acetabular osteotomy affect subsequent total hip arthroplasty? Arch Orthop Trauma Surg 135(3):407–415. https://doi.org/10.1007/s00402-015-2154-5 - DOI - PubMed

[10] Fukui K, Kaneuji A, Sugimori T, Ichiseki T, Matsumoto T (2015) Does rotational acetabular osteotomy affect subsequent total hip arthroplasty? Arch Orthop Trauma Surg 135(3):407–415. https://doi.org/10.1007/s00402-015-2154-5 - DOI - PubMed

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Total hip arthroplasty after periacetabular osteotomy versus primary total hip arthroplasty: a propensity-matched cohort study

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Total hip arthroplasty after periacetabular osteotomy versus primary total hip arthroplasty: a propensity-matched cohort study

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Abstract

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