EP1.27 Revision Periacetabular Osteotomy enhances joint function and activity level in adult patients after failure of redirectional pelvic osteotomy

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ID: 331397
2026
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Abstract
Abstract Introduction There is a paucity in literature regarding clinical outcomes of revision periacetabular osteotomy (R-PAO) after failure of previous redirectional pelvic osteotomy. This study aimed to compare the surgical and patient-reported outcomes (PROMs) between R-PAO and primary PAO. Methods Patients undergoing R-PAO and primary PAO were matched in a 1:3 ratio for age, sex and surgical date with a minimum follow-up of one years. PROM assessment included scores for pain, joint functionality (mHHS - modified Harris-Hip; iHot12 - international Hip outcome tool-12) and activity level (UCLA - University of California Los Angeles activity scale). Postoperative outcomes were compared between the groups using analysis of covariance (ANCOVA) adjusted for preoperative values. Multivariable linear regression were used to identify predictors of postoperative outcome improvement. Results A total of 52 patients were included with a mean follow-up of 3.1 years. ANCOVA analysis showed, that R-PAO lead to similar improvements in joint function (mHHS -1.47, p=0.841; iHot-12 -7.93, p=0.349) and activity level (UCLA -0.28, p=0.532) compared to primary PAO. However, R-PAO resulted in a significant lower pain relief (NRS Pain 1.27, p=0.041). Multivariable linear regression analysis revealed, that preserved preoperative joint function (iHot-12 ß=0.795, p<0.001; mHHS ß=0.696, p<0.001) and activity level (UCLA ß=0.360, p<0.001), a lower BMI (iHot-12 ß= -2.011, p=0.002; UCLA ß= -0.120, p=0.041) and a sufficient postoperative anterior wall coverage (iHot-12 ß=0.849, p<0.001) are predictors of improved postoperative outcomes in both R-PAO and primary PAO. Conclusion Failure of hip preserving pelvic osteotomies can result in a substantial symptom burden and functional impairment. R-PAO represents a considerable treatment strategy that preserves the native hip joint and can lead to improved postoperative outcomes. However, postoperative outcomes after R-PAO remains inferior to those of primary PAO, due to the greater preoperative symptom burden.
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Authors Maximilian Fischer, Andreas Nitsch, Jens Goronzy, André Hofer, Georgi Iwan Wassilew
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.211
URL
https://doi.org/10.1093/jhps/hnag043.211
Keywords Keywords not found

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