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J Bone Joint Surg Am · May 2015
Rotational Acetabular Osteotomy for Osteoarthritis with Acetabular Dysplasia: Conversion Rate to Total Hip Arthroplasty within Twenty Years and Osteoarthritis Progression After a Minimum of Twenty Years.
- Ayumi Kaneuji, Tanzo Sugimori, Toru Ichiseki, Kiyokazu Fukui, Eiji Takahashi, and Tadami Matsumoto.
- Department of Orthopaedic Surgery, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, 920-0293 Japan. E-mail address for A. Kaneuji: kaneuji@kanazawa-med.ac.jp.
- J Bone Joint Surg Am. 2015 May 6; 97 (9): 726-32.
BackgroundWe investigated the rate of conversion to total hip arthroplasty by twenty years and radiographic findings at a minimum of twenty years after rotational acetabular osteotomy.MethodsBetween June 1986 and August 1991, we performed 172 rotational acetabular osteotomies in 168 patients with acetabular dysplasia. Of those, ninety-three hips (ninety-one patients), including twenty-three hips with pre-osteoarthritis, twenty-nine with initial osteoarthritis, and forty-one with advanced osteoarthritis, had clinical and radiographic findings available. The mean age of the patients was 32.4 years (range, twelve to forty-nine years). The duration of follow-up was a mean of twenty-three years (range, twenty to twenty-seven years) for seventy-six hips, excluding hips that underwent conversion to total hip arthroplasty.ResultsConversion to total hip arthroplasty by twenty years after surgery was performed in one hip (4%) with pre-osteoarthritis, two hips (7%) with initial osteoarthritis, and fourteen hips (34%) with advanced osteoarthritis. The hips with advanced osteoarthritis had a significantly higher rate of conversion to total hip arthroplasty than hips in the other stages did (p = 0.0005). At the latest follow-up or at conversion to total hip arthroplasty, the disease stage had not progressed in seventeen hips (74%) with pre-osteoarthritis, nineteen (66%) with initial osteoarthritis, and twenty-six (63%) with advanced osteoarthritis.ConclusionsThe progression of osteoarthritis after rotational acetabular osteotomy was not detected for at least twenty years in most hips with either pre-osteoarthritis or initial osteoarthritis in this cohort. Rotational acetabular osteotomy may delay conversion to total hip arthroplasty in advanced osteoarthritis.Level Of EvidenceTherapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.
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