• Vincent J Leopold, Christian Hipfl, Carsten Perka, Sebastian Hardt, and Luis Becker.
• Center for Musculoskeletal Surgery, University Hospital Berlin, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117, Berlin, Germany. vincent.leopold@charite.de.
• Arch Orthop Trauma Surg. 2024 Mar 1; 144 (3): 106510701065-1070.

BackgroundConflicting evidence exists regarding outcomes in middle-aged patients undergoing periacetabular osteotomy (PAO) for symptomatic developmental dysplasia of the hip (DDH).AimsTo compare patient reported outcomes (PROMs) of middle-aged PAO patients with younger patient groups.MethodsRetrospective analysis of prospectively collected data of PAO patients between 01/2015 and 06/2017 at a single orthopedic university center with a primary diagnosis of symptomatic DDH. The cohort was divided into four age groups and compared: < 20, 20-30, 30-40 and > 40 years. Joint function was assessed using iHOT-12, mHHS and SHV. Activity level was assessed using UCLA Activity score. Patient satisfaction and pain were assessed on the numerical rating scale 0-10. Conversion rates to THA were assessed.ResultsOut of 202 PAOs, 120 cases with complete data were included. Mean follow-up was 63 months (range 47-81 months). Eighteen patients were < 20 years old, 54 were 20-30 years, 37 were 30-40 years, 11 patients were older than 40. No significant differences were observed for preoperative or postoperative iHOT-12 (p = 0.898; p = 0.087), mHHS (p = 0.878; p = 0.103), SHV (p = 0.602; p = 0.352) or UCLA (p = 0.539; p = 0.978) between groups. Improvement deltas were also not significantly different for all PROMs. Postoperative patient satisfaction was similar between groups (p = 0.783).ConclusionPatients with symptomatic DDH may benefit from PAO even at middle age with similar outcomes and pre- to postoperative improvements as younger age groups. Indication should be based on biological age and preoperative joint condition rather than age.© 2023. The Author(s).

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