DOS BULLETIN - Dansk Ortopædisk Selskab

2010-378_DOS nr. 3 2010 29/09/10 10:08 Side 121
Periacetabular osteotomy in the treatment of anterior
femuroacetabular impingement (FAI) caused by
acetabular retroversion
Ole Ovesen, Søren Overgaard
Dept of Orthopaedic Surgery and Traumatology.
Odense University Hospital
Background: The retroverted acetabulum can lead to FAI and has been
acknowledged as a pre-osteoarthritic (OA) abnormality. This abnormality can
be corrected by a periacetabular osteotomy (PAO) and reorientation of acetabulum
Purpose: Was to evaluate disease specific outcome (HHS), health related quality
of life (EQ5D), achieved radiographic corrections, postoperative activity,
satisfaction and any complications related to surgery
Methods: Since may 2004 27 PAOs were done due to acetabular retroversion.
Inclusion criteria were symptomatic hip pain and radiographic proven retroversion
of the acetabulum. The correction consisted of a combined flexion/internal
rotation and, if necessary, an adduction. In order to achieve a sufficient correction,
a new modification of the procedure has been introduced, consisting of
removal of a wedge of iliac bone. Eigth patients were excluded from this analysis
due to combined surgery or a follow up shorter than 6 months. HHS,
EQ5D, pain on a VAS-scale after 30 min of walk and intraoperative variables
were registered prospectively. The acetabular retroversion in terms of “figure of
8” and “posterior wall sign” was evaluated and quantitated on pre- and postoperative
pelvic radiographs in addition to the lateral center edge (LCE) – and
acetabular index (AA)angle. In one case preoperative radiographs were no
longer available. Finally a questionnaire was sent to evaluate the patients subjective
estimation regarding level of activity , “willingness to repeat the procedure”
and EQ5D.
Findings: No major complications were encountered. Average (95% cfi) HHS
improved from 72 (69-75)-96 (93-100), EQ5D from 0.71(0.65-0.76) –
0.92(0.86- 0.97) and pain from 6.3(5.4-7.2) – 0.6 (0.1-1.0) (p