FP7.9 Long-Term Hip Survivorship and Patient-Reported Outcomes of Periacetabular Osteotomy: The Washington University Experience
Bibliographic record
Abstract
Abstract Background: The Bernese periacetabular osteotomy (PAO) has become the gold standard acetabular reorientation procedure in the treatment of symptomatic acetabular dysplasia since first performed 39 years ago. There is a paucity of data on the long-term outcomes of this procedure. In this study, we assessed the long-term hip survival and patient-reported outcomes of PAO used to treat symptomatic acetabular dysplasia. Methods: We evaluated 127 hips at an average of 16 years postoperatively with a minimum follow-up of 13 years; 109 hips completed the follow-up. Hips were evaluated using a modified Harris Hip Score (mHHS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale score. A WOMAC pain score of ≥10 and/or mHHS of ≤70 were considered to indicate a clinically symptomatic hip. The Kaplan-Meier analysis assessed survivorship with an endpoint of total hip arthroplasty (THA). Results: Of the 109 hips that completed follow-up, 16.5% (n=18) underwent THA at an average of 13.5 years (range: 1.4 - 20.6 years), 2.8 % (n=3) hips underwent revision PAO at an average of 3.4 years, and 0.9 % (n=1) underwent revision hip arthroscopy at 1.8 years. A total of 87 hips (79.8%) were free of revision and/or THA with a mean mHHS of 85.1 ± 16.6 and a mean WOMAC pain score of 2.9 ± 4.8 at the 15 year follow-up. Of the 87 hips that did not undergo THA or revision, 19.5 % (n=17) were symptomatic based on a WOMAC pain score≥10 and/or mHHS ≤70. Kaplan-Meier analysis revealed a survival rate without conversion to THA of 97.1 % (95% confidence interval [CI]: 91.5%, 99.1%) at 10 years, 93.3% (95% CI: 86.4%, 96.8%) at 15 years, and 71.5 % (95% CI: 60.0%, 83.7%) at 20 years postoperatively. Conclusions: This study demonstrates that in patients with symptomatic acetabular dysplasia, preservation of the native hip can be improved through the Bernese periacetabular osteotomy with most hips surviving beyond 15 years post-operatively. A third of patients undergoing a PAO clinically failed for pain or function. Only half of these patients required conversion to Total hip arthroplasty occurring, on average, over 10 years after PAO.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 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".