Similar Clinical Outcomes for THAs With and Without Prior Periacetabular Osteotomy

Introduction Some patients opt to undergo conversion to a THA for continued pain or progression of hip arthritis after periacetabular osteotomy. Whether patients are at greater risk for postoperative complications, revision THA, poor clinical outcomes, or compromised radiographic results after periacetabular osteotomy is debatable. Questions/purposes When compared with a matched cohort of patients who underwent THAs for developmental dysplasia of the hip (DDH) without previous periacetabular osteotomy, we asked whether a THA after a periacetabular osteotomy has (1) a higher complication rate, (2) a higher likelihood of resulting in revision THA, (3) comparable improvements in Harris hip score, and (4) comparable radiographic results. Patients and Methods A multicenter retrospective review of 562 patients undergoing 645 periacetabular osteotomies was performed. Twenty-three hips in 22 patients underwent a THA after periacetabular osteotomy. The patients were matched for age, sex, and BMI with 23 hips in 23 patients with DDH undergoing THA without a history of periacetabular osteotomy. Minimum followup for both groups of patients was 2 years (mean, 10 ± 4 years and 6 ± 4 years, respectively). Comparisons were made to answer the study questions based on a retrospective review from prospectively maintained registries of clinical and radiographic information at two participating centers. Results With the numbers available, there was no difference in complication or revision rates between the two groups (p = 0.489 and 1.000, respectively); however, a post hoc power analysis showed our study was underpowered to detect a difference in the rate of postoperative complications or revision THA. There was marked improvement in Harris hip score with THA after periacetabular osteotomy (p