Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?

Clin Orthop Relat Res. 2011 Feb;469(2):447-53. doi: 10.1007/s11999-010-1544-9.

Abstract

Background: The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients.

Questions/purposes: We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males.

Patients and methods: We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months).

Results: We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively.

Conclusions: Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males.

Level of evidence: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acetabulum / diagnostic imaging
  • Acetabulum / pathology
  • Acetabulum / surgery*
  • Adolescent
  • Adult
  • Calcinosis / epidemiology
  • Calcinosis / etiology
  • Calcinosis / pathology
  • Femur / diagnostic imaging
  • Femur / pathology
  • Femur / surgery*
  • Hip Dislocation / diagnostic imaging
  • Hip Dislocation / pathology
  • Hip Dislocation / surgery*
  • Hip Joint / pathology
  • Hip Joint / physiopathology
  • Hip Joint / surgery
  • Humans
  • Male
  • Middle Aged
  • Osteotomy / adverse effects*
  • Osteotomy / methods
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology*
  • Postoperative Complications / pathology
  • Radiography
  • Range of Motion, Articular
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Young Adult