Abstract
Purpose
The purpose of this study was to compare early patient reported outcomes after staged
versus combined hip arthroscopy and periacetabular osteotomy for hip dysplasia.
Methods
A prospective database was retrospectively reviewed to identify patients that underwent
combined or staged hip arthroscopy and PAO from 2012-2020. Patients were excluded
if they were >40 years of age, had prior ipsilateral hip surgery, or did not have
at least 12-24 month postoperative PRO data. PROs included the Hip Outcomes Score
(HOS) Activities of Daily Living (ADL) and Sports Subscale (SS), Non-Arthritic Hip
Score (NAHS), and the Modified Harris Hip Score (mHHS). Paired t-tests were used to
compare preoperative to postoperative scores for both groups. Outcomes were compared
using linear regression adjusted for baseline characteristics including age, obesity,
cartilage damage, acetabular index, and procedure timing (early vs. late practice).
Results
Sixty-two hips were included in this analysis (39 combined, 23 staged). The average
length of follow up was similar between the combined and staged groups (20.8 vs. 19.6
months, p=0.192). Both groups reported significant improvements in PROs at final follow
up compared to preoperative scores (p<0.05 for all). There were no significant differences
in HOS-ADL, HOS-SS, NAHS, or mHHS scores between groups preoperatively or at 3, 6,
or 12 months postoperatively (p>0.05 for all). There was no significant difference
in PROs between the combined and staged groups at the final postoperative time point:
HOS-ADL (84.5 vs. 84.3, p=0.77), HOS-SS (76.0 vs. 79.2, p=0.68), NAHS (82.2 vs. 84.5,
p=0.79), mHHS (71.0 vs. 71.0, p=0.75) respectively.
Conclusion
Staged hip arthroscopy and PAO for hip dysplasia leads to similar PROs at 12-24 months
compared to combined procedures. This suggests that with careful and informed patient
selection, staging these procedures is an acceptable option for these patients and
does not change early outcomes.
Level of Evidence
Level III Retrospective Comparative
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Article info
Publication history
Accepted:
February 15,
2023
Received in revised form:
January 31,
2023
Received:
August 9,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
This work was presented as an abstract at the ISHA 2021 meeting and AAOS 2022 meeting
Caitlin A Orner, M.D. [email protected],
Brittany E Haws, M.D. [email protected]
John Reuter, BS. [email protected],
Raymond Kenney, M.D. [email protected],
P Christopher Cook, M.D. [email protected],
Brian D Giordano, M.D. [email protected]
Conflict of Interest Statement:
Brian D. Giordano is an Arthrex consultant and receives royalties and paid talks. However, this is not related to the submitted research.
Ethical Review Committee Statement:
This study was approved by the University of Rochester Institutional Review Board
This research was completed at the University of Rochester
Acknowledgements: None
Identification
Copyright
© 2023 by the Arthroscopy Association of North America
