Adolescents and young adults with hip dysplasia often have hip pain that limits their activities. When joint damage has not progressed beyond a certain point, hip preservation surgery is a valuable option. Peri-acetabular osteotomy (cutting around the ‘socket’ and repositioning it to cover the ball or femoral head) is a method of hip-preservation treatment.
A recent study in North America conducted by Novais et al evaluated the physical activity level and pain after periacetabular osteotomy (PAO) for the treatment of symptomatic hip dysplasia in adult patients.
Forty-seven female and four male patients with an average age of 27 years underwent a PAO. Physical activity levels and pain levels were assessed preoperatively, at 1 year, and at minimum 2 years postoperatively. Statistical analysis revealed that activity scores were generally higher at 1 year and remained higher when compared with preoperative scores. Pain scores were lower after surgery and remained lower during the period of follow-up.
As expected, younger age and higher activity level before surgery correlated with greater activity level after recovery from surgery.
Comments: Hip dysplasia can present in later in life (2nd-4th decades). These cases were not necessarily ‘missed diagnoses’ because they account for over 90% of all DDH cases, even in countries with socialized medicine and comprehensive infant screening practices. The IHDI is helping evaluate possible warning signs to identify these patients who did not have detectable hip instability at birth but may have had a shallow socket or a socket that didn’t develop properly.
This study demonstrates that in select patients that meet the criteria for PAO surgery, physical activity level improves after PAO.
Novais EN, Heyworth B, Murray K, Johnson VM, Kim YJ, Millis MB. Physical Activity Level Improves After Periacetabular Osteotomy for the Treatment of Symptomatic Hip Dysplasia. Clin Orthop Relat Res. 2012 Dec 5. [Epub ahead of print]