I s pelvic support osteotomy (PSO) suitable for ordinary high-riding hip dysplasia?

Yijian Huang; Hongbin Xie; Jiafeng Yi; Minzhi Yang; Xiangpeng Kong; Wei Chai

doi:10.1007/s00264-024-06177-6

^I ^{s pelvic support osteotomy (PSO) suitable for ordinary high-riding hip dysplasia?}

Int Orthop. 2024 Apr 15. doi: 10.1007/s00264-024-06177-6. Online ahead of print.

Authors

Yijian Huang^#^{1

2}, Hongbin Xie^#^{1

3}, Jiafeng Yi^{1

3}, Minzhi Yang^{1

2}, Xiangpeng Kong^#⁴, Wei Chai^#⁵

Affiliations

¹ Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Beijing, 100048, China.
² Graduate School, Chinese PLA Medical School, Beijing, People's Republic of China.
³ School of Medicine, Nankai University, Tianjin, 300071, China.
⁴ Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Beijing, 100048, China. 18810999609@163.com.
⁵ Senior Department of Orthopedics, the Fourth Medical Center of PLA General Hospital, No. 51 Fucheng Road, Beijing, 100048, China. chaiweiguanjie@sina.com.

^# Contributed equally.

PMID: 38619563
DOI: 10.1007/s00264-024-06177-6

Abstract

Purpose: Pelvic support osteotomy (PSO) is regarded to provide pelvic stability and improve abductor function to delay or even avoid total hip arthroplasty (THA) in young patients with high-riding hip dysplasia. However, some of these patients eventually have to undergo THA. Because of the double-angulation deformity of the femur after PSO, subsequent THA is challenging. This study aimed to analyze whether PSO surgery is suitable for high-riding hip dysplasia and summarize orthopaedic strategy during THA for patients with previous PSO.

Methods: This case-control study included eight cases of THA for high-riding hip dysplasia patients with previous PSO (study group) and 24 cases of high-riding hip dysplasia patients without any hip surgical therapy (control group) by a 1:3 match (from May 2018 to January 2022). We compared demographics and joint function before and after THA between two groups and recorded all patients' preoperative imaging data, surgical procedures, postoperative imaging data, and complications. The surgical techniques for patients with previous PSO were highlighted.

Results: There was no statistical difference between the two groups in demographic (p > 0.05). The study group had worse hip Harris score (HHS), range of motion (ROM), visual analogue scale (VAS), and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) (p < 0.05) compared with the control group before THA. All patients had concurrent THA and osteotomy at the proximal femur, but the study group experienced longer operation time (p = 0.047) with more blood loss (p = 0.027) and higher complication rate compared with the control group (p = 0.009). At the last follow-up, the study group's HHS, ROM, VAS, and WOMAC were still worse than those in the control group.

Conclusions: PSO did not improve the joint function of high-riding hip dysplasia patients but brought challenges to subsequent THA and affected the surgical outcomes. In short, we suggested that PSO is unsuitable for routine high-riding hip dysplasia patients.

Keywords: Complication; Hip dysplasia; PSO; S-ROM prosthesis; THA.