Joint Congruency as an Indication for Rotational Acetabular Osteotomy

Long-term results of periacetabular osteotomy for advanced-stage osteoarthritis secondary to developmental dysplasia of the hip are reportedly unsatisfactory compared with results for early-stage osteoarthritis. Other preoperative information that can be used to determine indications for periacetabular osteotomy is therefore important to avoid performing osteotomy in young patients with advanced-stage osteoarthritis who would not likely achieve substantial benefit. We retrospectively reviewed 47 patients (49 hips) with advanced-stage osteoarthritis who underwent rotational acetabular osteotomy (RAO) using preoperative congruency in abduction. The minimum postoperative followup was 8 years (mean, 12.3 years; range, 8-20 years) and mean age at surgery was 43.1 years (range, 30-59 years). At followup, osteoarthritic stage was improved in 12 hips, unchanged in 24 hips, and had progressed in 13 hips. Preoperative joint congruency in abduction was good in 13 hips, poor in 32 hips, and narrowed in four hips. Patients with better congruency in abduction had better results. We believe osteoarthritis with good congruency in abduction preoperatively remains a good indication for RAO even in advanced stages of disease. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.