FP1.4 Do Borderline Hips Show a Similar Response to Periacetabular Osteotomy as Frank Hip Dysplasia?A Cohort Study

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ID: 331306
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 Purpose Periacetabular osteotomy (PAO) is increasingly considered a treatment option for symptomatic borderline hip dysplasia (BHD) with a lateral center edge angle (LCEA) 20°–25°. However, whether BHD hips are likely to benefit from PAO compared to truly dysplastic hips (LCEA <20°) remains unclear. The aim of this study was to compare the early outcome of PAO in borderline hip dysplasia to frank dysplasia. Methods A prospective PAO database of patients undergoing PAO, willing to adhere to a 10-year follow-up, was utilized for this study. A total of 230 hips with a minimum follow-up of 1-year and that had undergone PAO by a single surgeon between January 2022 and December 2024 were included in this study. Patients were divided into BHD and frank dysplasia groups based on LCEA as frequently applied in the literature. The University of California and Los Angeles activity scale (UCLA), Hip Disability and Osteoarthritis Outcome Score – Physical Function Shortform (HOOS-PS), Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), International Hip Outcome Tool-12 (iHOT-12), Harris Hip Score (HHS), modified Harris Hip Score (mHHS), German Forgotten Joint Score (G-FJS) and Postel Merle d’Aubigné (PMA) score were assessed at mean follow-up of 17-21 months. Group comparisons were performed using analysis of variance (ANOVA). Results Most patient-reported outcome measures (PROMs showed significant preoperative differences between groups and were inferior in the BHD group. At final follow-up all PROMs improved significantly in both groups compared to baseline. No significant differences between patients with BHD and frank dysplasia were observed at final follow-up. The improvement in UCLA was significantly greater in the BHD group (p=0.043). Conclusion Patients with BHD benefit significantly from PAO. The magnitude of clinical improvement is comparable to that observed in patients with more severe dysplasia. The typically inferior preoperative PROMs in the BHD group were no longer seen at final follow-up. These findings suggest that patients with BHD commonly present with inferior scores in a hip clinic, likely due to delayed diagnosis of instability. However, they are likely to expect the same benefit from PAO surgery as patients with frank hip dysplasia.
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Authors Drmed Chiara Heller, Drmed Sufian S Ahmad, Drmed Marco Hartlé, Quentin Karisch, Justus Stamp
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.004
URL
https://doi.org/10.1093/jhps/hnag043.004
Keywords Keywords not found

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