Total hip arthroplasty after periacetabular and intertrochanteric valgus osteotomy

Abstract Background We performed periacetabular osteotomy (PAO) combined with intertrochanteric valgus osteotomy (TVO) to obtain better congruity for patients with acetabular dysplasia and non-spherical femoral head. These patients with PAO combined TVO demonstrate long-term progression of osteoarthritis, thereby needing conversion to total hip arthroplasty (THA) and is difficult due to morphological changes. The objective of the present study was to investigate outcomes of patients who underwent THA after PAO combined TVO. Methods We performed 3groups case-control study. The participants were 20 patients (20 hips) who underwent THA after PAO combined TVO (PAO-TVO group); these patients had a mean age at surgery of 56.3 years and underwent postoperative follow-up for a mean period of 6.8 years. For the control group, we included 53 patients (57 joints) who underwent THA after PAO and 76 patients (80 joints) who underwent primary THA for hip dysplasia matching age, sex, and time of surgery. Results Harris hip score at the last follow-up was significantly poorer in PAO-TVO group compare with PAO group and Primary group. SF-36 of PCS was significantly poorer in PAO-TVO group compared with Primary group. The socket position in the PAO-TVO group was significantly superior and lateral compared with that in the primary THA group. Considering socket placement in Lewinnek’s safe zone and stem malalignment, there were no significantly difference in the 3 groups. Conclusion Harris hip score and SF36-PCS for THA after PAO combined TVO were significantly poorer compared to those of primary THA.