Abstract
Study Design. Retrospective clinical and radiographic review of patients after Bernese periacetabular osteotomy for symptomatic congenital hip dysplasia. Introduction. The Bernese periacetabular osteotomy for the treatment of symptomatic congenital hip dysplasia is known to be a complex operative procedure. Several authors reported significant percentages of peri- and postoperative complications.
Objective.The aim of our study was to reveal whether the incidence as well as the grade of complications affect the postoperative outcome which was determined by the short form (SF) 36 and the Western Ontario McMasters osteoarthritis (WOMAC) questionnaires.
Methods. A consecutive series of 50 patients with 60 hips operated between 1988 and 2000 were investigated retrospectively with a mean follow up period of 32 months.
Results. With an incidence of 30% a lesion of the lateral cutaneus nerve occurred. In 10% a peroneal nerve palsy was diagnosed immediate postoperatively, with 4% persistent neurological deficit presented at one year follow up. Several other minor and major complications occurred with an overall complication rate of 68%. According to the severity of complications two groups of patients were identified. Statistical analysis did not reveal any difference between the results of the SF-36 (p=0.2) and WOMAC (p=0.09) questionnaires. Radiological analysis revealed a deterioration of osteoarthritis in 32% of our patients. These patients predominantly judged their postoperative results poor to fair (r=0.71). 76% rated the operation as successful and 64% would have surgery again. The subjective estimation of patients health status postoperatively was significantly reduced compared to an age matched healthy reference group (p=0.0001).
Conclusion. Despite the high incidence of complications 76% of the patients rated the operation as successful. 32% of the patients faced a deterioration of osteoarthritis. The postoperative results after Bernese periacetabular osteotomy are rather more influenced by the progression of osteoarthritis than by the occurrence of perioperative complications.
Theses abstracts were prepared by Professor Roger Lemaire. Correspondence should be addressed to EFORT Central Office, Freihofstrasse 22, CH-8700 Küsnacht, Switzerland.
