Purpose
To systematically review the literature and report the rate of return to sport (RTS)
in athletes following periacetabular osteotomy (PAO) for symptomatic hip dysplasia.
Methods
A literature search of the PubMed, Embase, and Cochrane Library databases was performed
using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines
for clinical studies reporting on athletes undergoing PAO surgery for symptomatic
hip dysplasia. A quality assessment was performed using the Methodological Index of
Non-Randomized Studies (MINORS) grading system. Data collection included study characteristics,
demographics, radiographic measurements, rate and timing of RTS, baseline and most
recent patient-reported outcomes (PROs), and subsequent surgeries.
Results
Six studies met inclusion criteria with 341 patients undergoing PAO. There were 2
level III and 4 level IV studies, with an average MINORS score of 11. Preoperative
and postoperative lateral center edge angles ranged from 8° to 18° and 23° to 41.3°,
respectively. One study reported solely on dancers with a 63% rate of RTS at 1 year
postoperatively. Two other studies reported RTS of 80% and 82% for multiple sports,
with slightly lower rates (73% and 78%) in competitive athletes. Three studies demonstrated
a comparable distribution of sports participation, from the preoperative to postoperative
period, in low-impact (61.4% to 72.1% and 63.7% to 85.7%), moderate-impact (10.3%
to 21.0% and 4.3% to 25.4%), and high-impact (8.5% to 17.6% and 5.1% to 10.8%) sports.
Three studies reported time to RTS after PAO, ranging from 8.8 to 12.8 months. Of
the 3 studies noting reasons for not returning to sport, concerns related to the operative
hip ranged from 36.4% to 67%. Of the studies that reported both preoperative and postoperative
PROs, improvements in all values were observed, with modified Harris Hip Scores and
Hip Disability Osteoarthritis Outcome Scores at most recent follow-up ranging from
81 to 95 and 72 to 93, respectively.
Conclusions
In athletes with symptomatic hip dysplasia undergoing PAO, postoperative participation
in low-, moderate-, and high-impact sports was observed, with greater than 70% RTS
for competitive athletes. These findings suggest that PAO, with appropriate indications,
is an efficacious treatment option in this active patient population with severe dysplasia.
Level of Evidence
Level IV, systematic review of level III and IV studies.
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Article info
Publication history
Published online: December 13, 2022
Accepted:
December 7,
2022
Received:
November 18,
2022
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study was performed in accordance with the ethical standards in the 1964 Declaration of Helsinki and was carried out in accordance with relevant regulations of the US Health Insurance Portability and Accountability Act. Details that might disclose the identity of the subjects under study have been omitted. This study was approved by the institutional review board (IRB ID: 5276).
Identification
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© 2022 by the Arthroscopy Association of North America
