Zaltz, J Bone Joint Surg Am 2014 - Complications Associated with the Periacetabular Osteotomy: A Prospective Multicenter Study - Article Summary

Complications Associated with the Periacetabular Osteotomy: A Prospective Multicenter Study

Zaltz, Clohisy, et al.·J Bone Joint Surg Am·2014·159 citations·Prospective cohort

Background

The purpose of this prospective multicenter study was to determine and categorize all complications associated with the periacetabular osteotomy performed by experienced surgeons.

Methods

We prospectively analyzed perioperative complications in 205 consecutive unilateral periacetabular osteotomies performed at 7 institutions by 10 surgeons.
All perioperative complications were recorded at an average of 10 weeks and one year after surgery in standardized fashion using a validated complication grading scheme applied to hip preservation procedures.
The mean patient age was 25.4 years.
There were 143 female and 62 male patients.
The most common diagnosis was developmental acetabular dysplasia, and concomitant procedures most commonly included femoral osteochondroplasty (58%) or hip arthroscopy (20%), which could include labral repair or resection.

Results

Major complications (grade III or IV) occurred in 12 patients (5.9%).
7 complications were evident at the 10-week visit and 5 at the one-year visit.
9 of the complications required a second surgical intervention, including repair for acetabular migration or implant adjustment (4 patients), incision and drainage for a deep infection (2 patients), and heterotopic bone resection, contralateral peroneal nerve decompression, and posterior column fixation (one patient each).
3 thromboembolic complications were managed medically.
There were no vascular injuries, permanent nerve palsies, intra-articular osteotomies and/or fractures, or acetabular osteonecrosis.
The most common grade-I or II complication was asymptomatic heterotopic ossification.

Conclusions

For surgeons experienced with the periacetabular osteotomy, it is a safe procedure but is associated with a 5.9% risk of grade-III or IV complications beyond the learning curve. The majority of these complications are resolved without permanent disability.

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

Supplemental

Complications Associated with the Periacetabular Osteotomy: A Prospective Multicenter Study.

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Complications Associated with the Periacetabular Osteotomy: A Prospective Multicenter Study

Zaltz, Clohisy, et al.·J Bone Joint Surg Am·2014·159 citations·Prospective cohort

Free Full Text·DOI·PubMed

Background

The purpose of this prospective multicenter study was to determine and categorize all complications associated with the periacetabular osteotomy performed by experienced surgeons.

Methods

We prospectively analyzed perioperative complications in 205 consecutive unilateral periacetabular osteotomies performed at 7 institutions by 10 surgeons.
All perioperative complications were recorded at an average of 10 weeks and one year after surgery in standardized fashion using a validated complication grading scheme applied to hip preservation procedures.
The mean patient age was 25.4 years.
There were 143 female and 62 male patients.
The most common diagnosis was developmental acetabular dysplasia, and concomitant procedures most commonly included femoral osteochondroplasty (58%) or hip arthroscopy (20%), which could include labral repair or resection.

Results

Major complications (grade III or IV) occurred in 12 patients (5.9%).
7 complications were evident at the 10-week visit and 5 at the one-year visit.
9 of the complications required a second surgical intervention, including repair for acetabular migration or implant adjustment (4 patients), incision and drainage for a deep infection (2 patients), and heterotopic bone resection, contralateral peroneal nerve decompression, and posterior column fixation (one patient each).
3 thromboembolic complications were managed medically.
There were no vascular injuries, permanent nerve palsies, intra-articular osteotomies and/or fractures, or acetabular osteonecrosis.
The most common grade-I or II complication was asymptomatic heterotopic ossification.

Conclusions

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

Background

The purpose of this prospective multicenter study was to determine and categorize all complications associated with the periacetabular osteotomy performed by experienced surgeons.

Methods

We prospectively analyzed perioperative complications in 205 consecutive unilateral periacetabular osteotomies performed at 7 institutions by 10 surgeons.
All perioperative complications were recorded at an average of 10 weeks and one year after surgery in standardized fashion using a validated complication grading scheme applied to hip preservation procedures.
The mean patient age was 25.4 years.
There were 143 female and 62 male patients.
The most common diagnosis was developmental acetabular dysplasia, and concomitant procedures most commonly included femoral osteochondroplasty (58%) or hip arthroscopy (20%), which could include labral repair or resection.

Results

Major complications (grade III or IV) occurred in 12 patients (5.9%).
7 complications were evident at the 10-week visit and 5 at the one-year visit.
9 of the complications required a second surgical intervention, including repair for acetabular migration or implant adjustment (4 patients), incision and drainage for a deep infection (2 patients), and heterotopic bone resection, contralateral peroneal nerve decompression, and posterior column fixation (one patient each).
3 thromboembolic complications were managed medically.
There were no vascular injuries, permanent nerve palsies, intra-articular osteotomies and/or fractures, or acetabular osteonecrosis.
The most common grade-I or II complication was asymptomatic heterotopic ossification.

Conclusions

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.

Background

The purpose of this prospective multicenter study was to determine and categorize all complications associated with the periacetabular osteotomy performed by experienced surgeons.

Methods

We prospectively analyzed perioperative complications in 205 consecutive unilateral periacetabular osteotomies performed at 7 institutions by 10 surgeons.
All perioperative complications were recorded at an average of 10 weeks and one year after surgery in standardized fashion using a validated complication grading scheme applied to hip preservation procedures.
The mean patient age was 25.4 years.
There were 143 female and 62 male patients.
The most common diagnosis was developmental acetabular dysplasia, and concomitant procedures most commonly included femoral osteochondroplasty (58%) or hip arthroscopy (20%), which could include labral repair or resection.

Results

Major complications (grade III or IV) occurred in 12 patients (5.9%).
7 complications were evident at the 10-week visit and 5 at the one-year visit.
9 of the complications required a second surgical intervention, including repair for acetabular migration or implant adjustment (4 patients), incision and drainage for a deep infection (2 patients), and heterotopic bone resection, contralateral peroneal nerve decompression, and posterior column fixation (one patient each).
3 thromboembolic complications were managed medically.
There were no vascular injuries, permanent nerve palsies, intra-articular osteotomies and/or fractures, or acetabular osteonecrosis.
The most common grade-I or II complication was asymptomatic heterotopic ossification.

Conclusions

Level of evidence: Therapeutic Level IV. Copyright remains with the authors and publisher.