Document Detail

Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?
MedLine Citation:
PMID:  20848246     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients.
QUESTIONS/PURPOSES: We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males.
PATIENTS AND METHODS: We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months).
RESULTS: We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively.
CONCLUSIONS: Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males.
LEVEL OF EVIDENCE: Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
K Ziebarth; J Balakumar; S Domayer; Y J Kim; M B Millis
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  469     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2011 Feb 
Date Detail:
Created Date:  2011-01-11     Completed Date:  2011-02-24     Revised Date:  2013-05-27    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  447-53     Citation Subset:  AIM; IM    
Department of Orthopaedic Surgery, Universitätsklinik Inselspital, University of Berne, Berne, Switzerland.
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MeSH Terms
Acetabulum / pathology,  radiography,  surgery*
Calcinosis / epidemiology,  etiology,  pathology
Femur / pathology,  radiography,  surgery*
Hip Dislocation / pathology,  radiography,  surgery*
Hip Joint / pathology,  physiopathology,  surgery
Middle Aged
Osteotomy / adverse effects*,  methods
Postoperative Complications / epidemiology,  etiology*,  pathology
Range of Motion, Articular
Retrospective Studies
Risk Factors
Severity of Illness Index
Young Adult

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