QUALITY OF LIFE AFTER PERIACETABULAR OSTEOTOMY IN PATIENTS OVER 40: A COMPARISON WITH THA

Abstract

Purpose: The purpose of this study was to compare postoperative quality of life in patients with dysplasia who underwent Bernese periacetabular osteotomy to those who had total hip arthroplasty.

Methods: Patients were included who had a diagnosis of dysplasia and were greater than 40 years old. Cases were patients who had a periacetabular osteotomy. Controls were patients who had undergone total hip arthroplasty. Patients were matched for gender, age, and comorbidity. There were 26 cases and 33 controls. Outcome tools were the Western Ontario McMaster Universities (WOMAC) osteoarthritis index, the SF-12, and the Arthroplasty Satisfaction Scale. T-tests were used to compare means between the groups. The chi-squared test was used to compare the percentage of patients who had very good, good, or poor outcomes between the groups. WOMAC scores were normalized on a 0–100 scale with 0 being worst and 100 being best. A WOMAC score > 75 was considered very good, 65–75 good, and below 65 poor.

Results: The mean follow-up was just over 4 years in both groups. There was a clinically and statistically significant difference in WOMAC pain and function scores favouring the total hip patients. Mean WOMAC pain scores were 89 vs 71 (p< 0.0050). Mean WOMAC function scores were 91 vs74 (p< 0.005). Ninety-seven percent of total hip patients had a good or very good result vesus 73% of the osteotomy patients (p< 0.05).

Conclusions: Total hip arthroplasty gives a more consistent and better return of quality of life in patients over 40 when measured at a mean of 4 years after operation. Future research should be directed toward preoperative and intraoperative factors that could improve the outcome of patients having an osteotomy in this age group.