Activity Level Maintenance at 10-Year Minimum Follow-up Among Active Patients Undergoing Periacetabular Osteotomy
Bibliographic record
Abstract
Background: Periacetabular osteotomy (PAO) can treat pain, dysfunction, and decreased activity secondary to hip dysplasia. Patients’ pre- and postoperative activity can be measured using the University of California Los Angeles (UCLA) activity score, a validated questionnaire. Understanding return to and maintenance of activity at long-term follow-up after PAO is a priority for active patients. Purpose: To provide long-term follow-up of a previously published cohort that will help examine maintenance of activity after PAO, guide treatment decision-making, and inform patient counseling. Study Design: Case series; Level of evidence, 4. Methods: This prospective longitudinal cohort consisted of patients undergoing PAO between 2006 and 2013. Inclusion criteria included lateral center-edge angle <25°, highly active individuals (UCLA score ≥7), and 10-year minimum follow-up. UCLA, modified Harris Hip Score, and Western Ontario and McMaster Universities Osteoarthritis Index scores and descriptive information were obtained. P values <.05 were considered significant. Results: The cohort included 68 hips (86.1% follow-up; 61 patients), with 7 (10.3%) having additional surgery (4 total hip arthroplasty, 3 osteochondroplasty) at a mean 9.8 years (range, 6.0-15.8). Reoperated hips were excluded; the remaining 61 were analyzed. Mean age at PAO was 24.7 years (range, 14.7-44.8) with female predominance (74.1%). Mean follow-up was 12.5 years (range, 10.2-17.1). Of 61 hips, 54 (88.5%) either maintained high activity with a UCLA score ≥7 (n = 43; 70.5%) or had lower activity unrelated to the surgical hip (n = 11; 18.0%). When compared with preoperative values, the mean UCLA score decreased from 8.9 to 8.1 ( P = .009); the modified Harris Hip Score improved from 64.6 to 88.8 ( P < .001), with 49 of 61 hips (80.3%) achieving the minimal clinically important difference; and the Western Ontario and McMaster Universities Osteoarthritis Index pain score improved from 68.2 to 89.0 ( P < .001), with 35 of 51 hips (68.7%) achieving the minimal clinically important difference. Hips with PAO before age 25 years were more likely to be in higher activity groups at follow-up ( P = .030). Conclusion: Patients with hip dysplasia can be treated with PAO to help maintain activity and preserve the native hip. At long-term follow-up (mean, 12.5 years), 54 of 68 (79.4%) hips did not have additional surgery and either remained in the high activity group or had lower activity levels unrelated to the hip. PAO appears to be a durable hip preservation technique at 12.5-year follow-up for highly active patients.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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 source (direct Gemma or distilled Codex), 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".