Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia
Aims: Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefo...
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The British Editorial Society of Bone & Joint Surgery
2025-01-01
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| Series: | Bone & Joint Open |
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| Online Access: | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0038.R1 |
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| author | Maximilian Fischer Lars Nonnenmacher Andre Hofer Alexander Zimmerer Andreas Nitsch Rico Großjohann Sabrina Erdmann Georgi I. Wassilew |
| author_facet | Maximilian Fischer Lars Nonnenmacher Andre Hofer Alexander Zimmerer Andreas Nitsch Rico Großjohann Sabrina Erdmann Georgi I. Wassilew |
| author_sort | Maximilian Fischer |
| collection | DOAJ |
| description | Aims: Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefore, this study aimed to analyze the functional outcome and activity level in relation to patient sex with a minimum follow-up of two years after PAO for mild to severe hip dysplasia. Methods: A single-centre study was conducted, enrolling patients undergoing PAO and completing a preoperative and postoperative radiological and clinical outcome assessment. The PROMs were assessed using the modified Harris Hip Score (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) with the subscales for pain, sport, activities of daily living (ADL), and quality of life (QoL), and the University of California, Los Angeles (UCLA) activity score. Kendall’s tau were calculated for correlation analyses. Results: In total, 145 patients (28 male, 117 female) were included. The PROMs improved significantly across males and females at the latest follow-up. Female patients had significantly lower preoperative PROMs: mHHS (47 vs 57.4; p = 0.002); HOOS pain (44.9 vs 60; p = 0.003), sport (47 vs 57.4; p = 0.002), ADL (58.9 vs 69.3; p = 0.032), and QoL (26.8 vs 39.3; p = 0.009); and UCLA (5.6 vs 6.7, p = 0.042) scores. Males showed higher postoperative UCLA scores (7.5 vs 6.7; p = 0.03). Kendall’s tau showed significant negative correlation between BMI and UCLA scores in females and males (-0.21 to -0.29; p = 0.002/0.048), while BMI and HOOS sport (-0.16; p = 0.015) and ADL (-0.2; p = 0.003), as well as QoL (-0.14; p = 0.031) and preoperative acetabular inclination (-0.13; p = 0.049) were only significantly negatively correlated in females. Conclusion: Patient sex affects PROMs before and after PAO. Female patients experience higher improvement in hip function and activity level, due to poorer preoperative PROMs than males. Thus, these data are particularly interesting in providing preoperative guidance regarding postoperative outcome expectations. Cite this article: Bone Jt Open 2024;6(1):35–42. |
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| institution | Kabale University |
| issn | 2633-1462 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The British Editorial Society of Bone & Joint Surgery |
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| spelling | doaj-art-9bd22eba6aa6433fba553c3b27802aec2025-01-28T05:38:53ZengThe British Editorial Society of Bone & Joint SurgeryBone & Joint Open2633-14622025-01-0161354210.1302/2633-1462.61.BJO-2024-0038.R1Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasiaMaximilian Fischer0Lars Nonnenmacher1Andre Hofer2Alexander Zimmerer3Andreas Nitsch4Rico Großjohann5Sabrina Erdmann6Georgi I. Wassilew7Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyCenter for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, GermanyAims: Periacetabular osteotomy (PAO) is well established for acetabular reorientation and has shown successful improvement in patient-reported outcome measures (PROMs). Nevertheless, studies focusing on postoperative outcomes related to patient individual factors are still underrepresented. Therefore, this study aimed to analyze the functional outcome and activity level in relation to patient sex with a minimum follow-up of two years after PAO for mild to severe hip dysplasia. Methods: A single-centre study was conducted, enrolling patients undergoing PAO and completing a preoperative and postoperative radiological and clinical outcome assessment. The PROMs were assessed using the modified Harris Hip Score (mHHS), the Hip disability and Osteoarthritis Outcome Score (HOOS) with the subscales for pain, sport, activities of daily living (ADL), and quality of life (QoL), and the University of California, Los Angeles (UCLA) activity score. Kendall’s tau were calculated for correlation analyses. Results: In total, 145 patients (28 male, 117 female) were included. The PROMs improved significantly across males and females at the latest follow-up. Female patients had significantly lower preoperative PROMs: mHHS (47 vs 57.4; p = 0.002); HOOS pain (44.9 vs 60; p = 0.003), sport (47 vs 57.4; p = 0.002), ADL (58.9 vs 69.3; p = 0.032), and QoL (26.8 vs 39.3; p = 0.009); and UCLA (5.6 vs 6.7, p = 0.042) scores. Males showed higher postoperative UCLA scores (7.5 vs 6.7; p = 0.03). Kendall’s tau showed significant negative correlation between BMI and UCLA scores in females and males (-0.21 to -0.29; p = 0.002/0.048), while BMI and HOOS sport (-0.16; p = 0.015) and ADL (-0.2; p = 0.003), as well as QoL (-0.14; p = 0.031) and preoperative acetabular inclination (-0.13; p = 0.049) were only significantly negatively correlated in females. Conclusion: Patient sex affects PROMs before and after PAO. Female patients experience higher improvement in hip function and activity level, due to poorer preoperative PROMs than males. Thus, these data are particularly interesting in providing preoperative guidance regarding postoperative outcome expectations. Cite this article: Bone Jt Open 2024;6(1):35–42.https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0038.R1hip dysplasiaperiacetabular osteotomyacetabular dysplasiahip preservationpromssex-related outcomepaofunctional outcomeperiacetabular osteotomypatient-reported outcome measures (proms)hipsbmiuniversity of california, los angeles (ucla) activity scorehip disability and osteoarthritis outcome scoremodified harris hip scoreclinical outcomes |
| spellingShingle | Maximilian Fischer Lars Nonnenmacher Andre Hofer Alexander Zimmerer Andreas Nitsch Rico Großjohann Sabrina Erdmann Georgi I. Wassilew Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia Bone & Joint Open hip dysplasia periacetabular osteotomy acetabular dysplasia hip preservation proms sex-related outcome pao functional outcome periacetabular osteotomy patient-reported outcome measures (proms) hips bmi university of california, los angeles (ucla) activity score hip disability and osteoarthritis outcome score modified harris hip score clinical outcomes |
| title | Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| title_full | Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| title_fullStr | Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| title_full_unstemmed | Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| title_short | Sex-related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| title_sort | sex related functional outcome after periacetabular osteotomy in mild to severe hip dysplasia |
| topic | hip dysplasia periacetabular osteotomy acetabular dysplasia hip preservation proms sex-related outcome pao functional outcome periacetabular osteotomy patient-reported outcome measures (proms) hips bmi university of california, los angeles (ucla) activity score hip disability and osteoarthritis outcome score modified harris hip score clinical outcomes |
| url | https://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.61.BJO-2024-0038.R1 |
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