Analysis Of The Influence Of The Change Of Acetabular Anteversion On The Outcome After The Bernese Periacetabular Osteotomy

Objective To investigate the beneficial effect of Acetabular anteversion(AA)correction on Harris score after Bernese periacetabular osteotomy(PAO)on the surgical outcomes.Methods This is a retrospectively study include 54 developmental dysplasia of the hip(DDH)patients,all of these individuals were collected from December 2004 to October 2018 in the arthroplasty department in the First Affiliated Hospital Of Shandong First Medical University.The changes of AA before and after the operation were measured with CT of the hip joint,and the influence of postoperative Acetabular anteversion on postoperative Harris score was evaluated using ROC curve.Patients were divided in three groups by the truncated value of postoperative Acetabular anteversion on the ROC curve.The pain intensity,claudication,Harris score,and progression of osteoarthritis among different groups were compared.Results The followed-up period was 5.37±3.66 years,90.75%of the patients were satisfied with the surgical effect.Post-OP AA was 17°(15°,19°).At the end of the follow-up,the Harris score was 93.62±4.03,the Harris pain score was 39.35±3.33,and the iHOT-12 score was 73(65.75,75),two of them were significantly higher than those before surgery(P<0.01,P<0.01,P=0.127).Postoperative complications including postoperative pain(in 2 patients),postoperative claudication(in 2 patients),progression of osteoarthritis(in 4 patients),postoperative pubic ramus nonunion(in 3 patients),and lateral femoral cutaneous nerve injury(in 4 patients)were observed.Two groups were divided according to the results of postoperative Harris score(HHS):average group(≤86 points)and excellent group(>86 points)to construct ROC curves.According to Youden index,the trap-off values of postoperative Acetabular anteversion were found,which were AA16.5° and AA12°respectively.The affected hips were then divided into three groups:AA<12° group(3 individuals),AA12°-16.5° group(21 individuals),AA>16.5 °(30 patients).The Harris score of AA<12° group was significantly lower than AA>16.5°group and AA12°-16.5° group,the difference was statistically significant(P<0.05).Conclusion In adult patients with DDH,Bernese periacetabular osteotomy can help DDH patients in a better Harris score.However,Acetabular anteversion<12°would decline its beneficial effect.