FP1.1 Long-term Survivorship of Periacetabular Osteotomy: a 15-year follow-up Study

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ID: 331192
2026
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Abstract
Abstract ICLB01 - The Instability Masterclass: Correcting Bone, Biology, and Bad Outcomes, Session Room 6 (BMCC Level 3), October 8, 2026, 10:30 - 12:30 Introduction Periacetabular osteotomy (PAO) effectively corrects symptomatic hip dysplasia but long-term survivorship with conversion to total hip arthroplasty (THA) as endpoint requires further definition. This study reports 15 years survivorship in a consecutive PAO cohort and identifies predictors of failure including age, preoperative Tönnis grade and lateral center-edge (LCE) angle correction. Patients and methods We reviewed 84 consecutive hips undergoing PAO (2008 to 2014) with a mean follow-up of 15 years. Mean age at surgery was 30.7±8.7 years; 75% of hips were female. Preoperative Tönnis distribution was 60.5% grade 0 (51 hips), 35% grade 1 (29 hips), 3.5% grade 2 (3 hips) and 1% grade 3 (1 hip). Mean preoperative LCE angle was 16.5°± 8.0°, increasing to 34.7°± 8.3° postoperatively (paired analysis, p<0.0001). The primary endpoint was conversion to THA; for failed hips, time-to-THA (years) was recorded. Kaplan–Meier analysis with THA as failure was used to describe hip survivorship over time. Comparisons between THA and non-THA groups used Fisher’s exact test (categorical) and Mann–Whitney U test (continuous), evaluating the association of age, LCE angles and Tönnis grade with failure. Results Overall, 13.2% hips (11/84) were converted to THA at a mean of 8.1±4.2 years after PAO. Kaplan–Meier analysis showed an estimated survivorship of approximately 90% at 10 years and 84% at 15 years. Hips that failed tended to have lower postoperative LCE angles (26°.0 ± 14.0°) compared to surviving hips (36.1°± 6.2°), while preoperative LCE values were comparable. The proportion of Tönnis ≥1 hips was 73% (8/11) among failures vs 34% (25/73) among preserved hips (p=0.021). Patients progressing to THA were, on average, older at the time of PAO than those who retained their native joint albeit not meeting the threshold of statistical significance. Conclusions PAO demonstrated good long-term durability, with only 13.2% requiring THA at a mean of 8.1 years and an estimated 15-year survivorship of about 84%. Higher Tönnis grade and suboptimal postoperative coverage, underlines the importance of early indication and precise acetabular reorientation. These 15-year data from 84 consecutive hips confirm PAO as an effective procedure for Tönnis 0-1 dysplasia when physiologic coverage is restored.
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Authors Alexander Vallone, MD Michele Oveglia, MD Giuseppe Mangiapane, MD Vittorio Bellotti, MD Alessandro Vanzetti, MD Enrique Vargas, MD Jorge Escalante, MD Carlomagno Cardenas, Manuel Ribas
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.001
URL
https://doi.org/10.1093/jhps/hnag043.001
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