Sexual function and pregnancy outcomes after periacetabular osteotomy: a systematic review
Bibliographic record
Abstract
Periacetabular osteotomy (PAO) is a surgical treatment of developmental dysplasia of the hip (DDH). This systematic review investigates the impact PAO has on sexual function and pregnancy through changes in patient-reported outcomes. A literature search of Medline, PubMed, EMBASE, and the Cochrane Library from 1996 to November 2023 was performed. Search terms included: 'periacetabular osteotomy', 'pelvic osteotomy', 'outcomes', 'sexual function', 'pregnancy', and 'childbirth'. Assessment of methodological quality was performed using the methodological index for nonrandomized studies (MINORS) criteria and Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) system. The search returned 560 papers, with 5 meeting the inclusion criteria. Sexual function improved over both short- and longer-term follow-up periods. 48.2% of patients had improved sexual function following PAO. Female patients reported greater improvement than males, who had a higher baseline score. No complications were documented in pregnancy or delivery compared to patients who had not had a PAO. Increased rates of caesarean sections (CSs) were seen in all studies (37.4%) compared to the European average. All five papers were calculated to be of low quality according to the MINORS criteria and low certainty according to the GRADE level of evidence. Patients receiving a PAO due to symptomatic DDH had improved sexual dysfunction due to a reduction in hip pain, but almost half of these patients may not appreciate any benefit. There is an increased likelihood of CS in patients post-PAO, with no reliable evidence for its necessity. Limitations of this review included poor quality and availability of evidence, as all studies were retrospective cohort studies. Further larger powered studies are required to assess the full impact of PAO on both sexual function and pregnancy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".