PMID- 33661717
OWN - NLM
STAT- MEDLINE
DCOM- 20210427
LR  - 20210427
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 49
IP  - 5
DP  - 2021 Apr
TI  - Correlation of Patient-Reported Outcomes After Periacetabular Osteotomy With 
      Femoral Head Coverage and Acetabular Orientation: A Single-Center Cohort Study.
PG  - 1209-1219
LID - 10.1177/0363546521992108 [doi]
AB  - BACKGROUND: Gaining a better understanding of the underlying pattern of 
      acetabular dysplasia 3-dimensionally can help better guide treatment and optimize 
      clinical outcomes after periacetabular osteotomy (PAO). PURPOSE: (1) To examine 
      the relationship between femoral head coverage before and after PAO for dysplasia 
      and patient-reported outcome measure (PROM) scores and (2) to assess if the 
      direction/orientation of correction of the acetabulum can be predicted based on 
      the Ottawa classification. STUDY DESIGN: Cohort study; Level of evidence, 3. 
      METHODS: A retrospective analysis of a prospectively collected database from a 
      single-center institutional registry of PAO was conducted, and PROM scores at a 
      minimum of 2 years were analyzed. A total of 79 hips (67 patients [56 female]; 
      mean age at surgery, 27.5 years [range, 15.8-53.7 years]) were available for 
      inclusion. According to the Ottawa classification, 54 hips (68.4%) had global 
      deficiency, 15 hips (18.9%) had posterior deficiency, and 10 hips (12.7%) had 
      anterior deficiency. Hip2Norm software was used to analyze the 3-dimensional 
      coverage of the femoral head. Statistical analysis was conducted to look at 
      significant predictors of improvements in PROMs using the minimal clinically 
      important difference (MCID) for the Hip disability and Osteoarthritis Outcome 
      Score (HOOS) Activities of Daily Living subscale. RESULTS: At a mean follow-up of 
      3.1 years (range, 2.0-7.4 years), all functional outcome scores improved 
      significantly. A postoperative total femoral coverage <75.7%, posterior coverage 
      (PC) <45.2%, and femoral head extrusion index >15.5% were all associated with not 
      reaching the MCID for the HOOS Activities of Daily Living subscale. Multivariate 
      analysis showed that PC was the single most important significant modifier 
      influencing functional outcomes after PAO for the treatment of acetabular 
      dysplasia, with an odds ratio of 6.0 (95% CI, 1.8-20.4; P = .004). One-way 
      analysis of variance showed a significant difference comparing the mean change in 
      radiographic measurements, that is, anterior coverage, PC, and total femoral 
      coverage, per the Ottawa classification (P < .001). CONCLUSION: Our study 
      demonstrated that postoperative femoral head coverage and acetabular orientation 
      were significant predictors of PROM scores. Classifying acetabular dysplasia into 
      3 groups based on the plane of instability could optimize the planning of PAO by 
      giving a better understanding of the 3-dimensional deformity.
FAU - Ibrahim, Mazen M
AU  - Ibrahim MM
AD  - Division of Orthopedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
AD  - Division of Orthopedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, 
      Ontario, Canada.
AD  - Faculty of Medicine, Helwan University, Cairo, Egypt.
FAU - Smit, Kevin
AU  - Smit K
AD  - Division of Orthopedic Surgery, Children's Hospital of Eastern Ontario, Ottawa, 
      Ontario, Canada.
FAU - Poitras, Stephane
AU  - Poitras S
AD  - School of Rehabilitation Sciences, University of Ottawa, Ottawa, Ontario, Canada.
FAU - Grammatopoulos, George
AU  - Grammatopoulos G
AD  - Division of Orthopedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
FAU - Beaule, Paul E
AU  - Beaule PE
AD  - Division of Orthopedic Surgery, The Ottawa Hospital, Ottawa, Ontario, Canada.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210304
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - *Acetabulum/surgery
MH  - Activities of Daily Living
MH  - Cohort Studies
MH  - Female
MH  - Femur Head/surgery
MH  - *Hip Dislocation/surgery
MH  - Humans
MH  - Osteotomy
MH  - Patient Reported Outcome Measures
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - acetabular coverage
OT  - acetabular dysplasia
OT  - patient-reported outcome
OT  - periacetabular osteotomy
EDAT- 2021/03/05 06:00
MHDA- 2021/04/28 06:00
CRDT- 2021/03/04 17:12
PHST- 2021/03/05 06:00 [pubmed]
PHST- 2021/04/28 06:00 [medline]
PHST- 2021/03/04 17:12 [entrez]
AID - 10.1177/0363546521992108 [doi]
PST - ppublish
SO  - Am J Sports Med. 2021 Apr;49(5):1209-1219. doi: 10.1177/0363546521992108. Epub 
      2021 Mar 4.