Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study

John C. Clohisy, Jeffrey Ackerman, Geneva Baca, Jack Baty, Paul E. Beaule, Young Jo Kim, Michael B. Millis, David A. Podeszwa, Perry L. Schoenecker, Rafael J. Sierra, Ernest L. Sink, Daniel J. Sucato, Robert T. Trousdale, Ira Zaltz

Research output: Contribution to journalReview article

36 Citations (Scopus)

Abstract

Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery. Methods: A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79% of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes. Results: Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8%) of the hips underwent early conversion to total hip arthroplasty, 12 (3%) required reoperation, and 26 (7%) experienced a major complication. Conclusions: This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)33-41
Number of pages9
JournalJournal of Bone and Joint Surgery - American Volume
Volume99
Issue number1
DOIs
StatePublished - 2017

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Osteotomy
Hip
Cohort Studies
Reoperation
Linear Models
Quality of Life
Prospective Studies
Pain
Hip Replacement Arthroplasties
Arthroplasty
Health Status
Decision Making
Body Mass Index
Outcome Assessment (Health Care)
Patient Reported Outcome Measures
Health
Therapeutics

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)
  • Orthopedics and Sports Medicine

Cite this

Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study. / Clohisy, John C.; Ackerman, Jeffrey; Baca, Geneva; Baty, Jack; Beaule, Paul E.; Kim, Young Jo; Millis, Michael B.; Podeszwa, David A.; Schoenecker, Perry L.; Sierra, Rafael J.; Sink, Ernest L.; Sucato, Daniel J.; Trousdale, Robert T.; Zaltz, Ira.

In: Journal of Bone and Joint Surgery - American Volume, Vol. 99, No. 1, 2017, p. 33-41.

Research output: Contribution to journalReview article

Clohisy, JC, Ackerman, J, Baca, G, Baty, J, Beaule, PE, Kim, YJ, Millis, MB, Podeszwa, DA, Schoenecker, PL, Sierra, RJ, Sink, EL, Sucato, DJ, Trousdale, RT & Zaltz, I 2017, 'Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study', Journal of Bone and Joint Surgery - American Volume, vol. 99, no. 1, pp. 33-41. https://doi.org/10.2106/JBJS.15.00798
Clohisy, John C. ; Ackerman, Jeffrey ; Baca, Geneva ; Baty, Jack ; Beaule, Paul E. ; Kim, Young Jo ; Millis, Michael B. ; Podeszwa, David A. ; Schoenecker, Perry L. ; Sierra, Rafael J. ; Sink, Ernest L. ; Sucato, Daniel J. ; Trousdale, Robert T. ; Zaltz, Ira. / Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study. In: Journal of Bone and Joint Surgery - American Volume. 2017 ; Vol. 99, No. 1. pp. 33-41.
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abstract = "Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery. Methods: A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79{\%} of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes. Results: Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8{\%}) of the hips underwent early conversion to total hip arthroplasty, 12 (3{\%}) required reoperation, and 26 (7{\%}) experienced a major complication. Conclusions: This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.",
author = "Clohisy, {John C.} and Jeffrey Ackerman and Geneva Baca and Jack Baty and Beaule, {Paul E.} and Kim, {Young Jo} and Millis, {Michael B.} and Podeszwa, {David A.} and Schoenecker, {Perry L.} and Sierra, {Rafael J.} and Sink, {Ernest L.} and Sucato, {Daniel J.} and Trousdale, {Robert T.} and Ira Zaltz",
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T1 - Patient-reported outcomes of periacetabular osteotomy from the prospective ANCHOR cohort study

AU - Clohisy, John C.

AU - Ackerman, Jeffrey

AU - Baca, Geneva

AU - Baty, Jack

AU - Beaule, Paul E.

AU - Kim, Young Jo

AU - Millis, Michael B.

AU - Podeszwa, David A.

AU - Schoenecker, Perry L.

AU - Sierra, Rafael J.

AU - Sink, Ernest L.

AU - Sucato, Daniel J.

AU - Trousdale, Robert T.

AU - Zaltz, Ira

PY - 2017

Y1 - 2017

N2 - Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery. Methods: A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79% of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes. Results: Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8%) of the hips underwent early conversion to total hip arthroplasty, 12 (3%) required reoperation, and 26 (7%) experienced a major complication. Conclusions: This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

AB - Background: Current literature describing the periacetabular osteotomy (PAO) is mostly limited to retrospective case series. Larger, prospective cohort studies are needed to provide better clinical evidence regarding this procedure. The goals of the current study were to (1) report minimum 2-year patient-reported outcomes (pain, hip function, activity, overall health, and quality of life), (2) investigate preoperative clinical and disease characteristics as predictors of clinical outcomes, and (3) report the rate of early failures and reoperations in patients undergoing contemporary PAO surgery. Methods: A large, prospective, multicenter cohort of PAO procedures was established, and outcomes at a minimum of 2 years were analyzed. A total of 391 hips were included for analysis (79% of the patients were female, and the average patient age was 25.4 years). Patient-reported outcomes, conversion to total hip replacement, reoperations, and major complications were documented. Variables with a p value of ≤0.10 in the univariate linear regressions were included in the multivariate linear regression. The backward stepwise selection method was used to determine the final risk factors of clinical outcomes. Results: Clinical outcome analysis demonstrated major clinically important improvements in pain, function, quality of life, overall health, and activity level. Increasing age and a body mass index status of overweight or obese were predictive of improved results for certain outcome metrics. Male sex and mild acetabular dysplasia were predictive of lesser improvements in certain outcome measures. Three (0.8%) of the hips underwent early conversion to total hip arthroplasty, 12 (3%) required reoperation, and 26 (7%) experienced a major complication. Conclusions: This large, prospective cohort study demonstrated the clinical success of contemporary PAO surgery for the treatment of symptomatic acetabular dysplasia. Patient and disease characteristics demonstrated predictive value that should be considered in surgical decision-making. Level of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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