Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy: Does obesity increase the risk of complications?

Eduardo N. Novais, Gorden D. Potter, Rafael J. Sierra, Young Jo Kim, John C. Clohisy, Perry L. Schoenecker, Robert T. Trousdale, Patrick M. Carry, Michael B. Millis

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: The Bernese periacetabular osteotomy (PAO) is frequently used to treat symptomatic acetabular dysplasia in the adolescent age group. Despite encouraging results, factors predictive of the development of postoperative complications remain poorly understood. The purpose of this study was to investigate whether obesity is a risk factor for complications following PAO in adolescents. Methods: A retrospective cohort study design was used to collect data from 3 different institutions. Children and adolescents (below 19 y of age) who underwent PAO and were followed for minimum of 12 months were included. Obesity was defined as a body mass index ≥95 percentile. The modified Clavien-Dindo classification was used to grade complications. A logistic regression analysis was used to identify factors related to the development of a complication that required treatment outside of routine postoperative care (complication grades II to V). Changes in radiographic parameters including Tönnis acetabular roof angle, anterior center-edge angle, and lateral centeredge angle among obese versus nonobese subjects were also evaluated. Results: The mean age at surgery among the 84 adolescents included in the study was 16.5 years (range, 12 to 19 y). A total of 11% of the population was considered obese. Obesity (P=0.0047) was the only variable significantly associated with the development of a complication. After controlling for study site, the odds of an obese subject developing a complication were 10 [95% confidence interval (CI), 1.89-59.8] times the odds of a nonobese subject developing a complication. There was no difference in the magnitude of change in anterior center-edge angle (P=0.1251), lateral center-edge angle (P=0.9774), or Tönnis (P=0.5770) angular correction that was achieved among the obese versus nonobese subjects following surgery. Conclusions: The Bernese PAO allows for adequate radiographic correction of acetabular dysplasia among obese and nonobese adolescents. However, the hip preservation surgeon should be aware of the higher risk of complications among obese adolescents undergoing PAO for the treatment of symptomatic acetabular dysplasia.

Original languageEnglish (US)
Pages (from-to)561-564
Number of pages4
JournalJournal of Pediatric Orthopaedics
Volume35
Issue number6
StatePublished - 2015

Fingerprint

Osteotomy
Obesity
Therapeutics
Postoperative Care
Hip
Body Mass Index
Cohort Studies
Retrospective Studies
Age Groups
Logistic Models
Regression Analysis
Confidence Intervals
Population

Keywords

  • Acetabular dysplasia
  • Adolescent hip
  • Obesity
  • Periacetabular osteotomy
  • Postoperative complications

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Novais, E. N., Potter, G. D., Sierra, R. J., Kim, Y. J., Clohisy, J. C., Schoenecker, P. L., ... Millis, M. B. (2015). Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy: Does obesity increase the risk of complications? Journal of Pediatric Orthopaedics, 35(6), 561-564.

Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy : Does obesity increase the risk of complications? / Novais, Eduardo N.; Potter, Gorden D.; Sierra, Rafael J.; Kim, Young Jo; Clohisy, John C.; Schoenecker, Perry L.; Trousdale, Robert T.; Carry, Patrick M.; Millis, Michael B.

In: Journal of Pediatric Orthopaedics, Vol. 35, No. 6, 2015, p. 561-564.

Research output: Contribution to journalArticle

Novais, EN, Potter, GD, Sierra, RJ, Kim, YJ, Clohisy, JC, Schoenecker, PL, Trousdale, RT, Carry, PM & Millis, MB 2015, 'Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy: Does obesity increase the risk of complications?', Journal of Pediatric Orthopaedics, vol. 35, no. 6, pp. 561-564.
Novais, Eduardo N. ; Potter, Gorden D. ; Sierra, Rafael J. ; Kim, Young Jo ; Clohisy, John C. ; Schoenecker, Perry L. ; Trousdale, Robert T. ; Carry, Patrick M. ; Millis, Michael B. / Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy : Does obesity increase the risk of complications?. In: Journal of Pediatric Orthopaedics. 2015 ; Vol. 35, No. 6. pp. 561-564.
@article{cd090b48b7d9417ea103f1755d4b4984,
title = "Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy: Does obesity increase the risk of complications?",
abstract = "Background: The Bernese periacetabular osteotomy (PAO) is frequently used to treat symptomatic acetabular dysplasia in the adolescent age group. Despite encouraging results, factors predictive of the development of postoperative complications remain poorly understood. The purpose of this study was to investigate whether obesity is a risk factor for complications following PAO in adolescents. Methods: A retrospective cohort study design was used to collect data from 3 different institutions. Children and adolescents (below 19 y of age) who underwent PAO and were followed for minimum of 12 months were included. Obesity was defined as a body mass index ≥95 percentile. The modified Clavien-Dindo classification was used to grade complications. A logistic regression analysis was used to identify factors related to the development of a complication that required treatment outside of routine postoperative care (complication grades II to V). Changes in radiographic parameters including T{\"o}nnis acetabular roof angle, anterior center-edge angle, and lateral centeredge angle among obese versus nonobese subjects were also evaluated. Results: The mean age at surgery among the 84 adolescents included in the study was 16.5 years (range, 12 to 19 y). A total of 11{\%} of the population was considered obese. Obesity (P=0.0047) was the only variable significantly associated with the development of a complication. After controlling for study site, the odds of an obese subject developing a complication were 10 [95{\%} confidence interval (CI), 1.89-59.8] times the odds of a nonobese subject developing a complication. There was no difference in the magnitude of change in anterior center-edge angle (P=0.1251), lateral center-edge angle (P=0.9774), or T{\"o}nnis (P=0.5770) angular correction that was achieved among the obese versus nonobese subjects following surgery. Conclusions: The Bernese PAO allows for adequate radiographic correction of acetabular dysplasia among obese and nonobese adolescents. However, the hip preservation surgeon should be aware of the higher risk of complications among obese adolescents undergoing PAO for the treatment of symptomatic acetabular dysplasia.",
keywords = "Acetabular dysplasia, Adolescent hip, Obesity, Periacetabular osteotomy, Postoperative complications",
author = "Novais, {Eduardo N.} and Potter, {Gorden D.} and Sierra, {Rafael J.} and Kim, {Young Jo} and Clohisy, {John C.} and Schoenecker, {Perry L.} and Trousdale, {Robert T.} and Carry, {Patrick M.} and Millis, {Michael B.}",
year = "2015",
language = "English (US)",
volume = "35",
pages = "561--564",
journal = "Journal of Pediatric Orthopaedics",
issn = "0271-6798",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Surgical treatment of adolescent acetabular dysplasia with a periacetabular osteotomy

T2 - Does obesity increase the risk of complications?

AU - Novais, Eduardo N.

AU - Potter, Gorden D.

AU - Sierra, Rafael J.

AU - Kim, Young Jo

AU - Clohisy, John C.

AU - Schoenecker, Perry L.

AU - Trousdale, Robert T.

AU - Carry, Patrick M.

AU - Millis, Michael B.

PY - 2015

Y1 - 2015

N2 - Background: The Bernese periacetabular osteotomy (PAO) is frequently used to treat symptomatic acetabular dysplasia in the adolescent age group. Despite encouraging results, factors predictive of the development of postoperative complications remain poorly understood. The purpose of this study was to investigate whether obesity is a risk factor for complications following PAO in adolescents. Methods: A retrospective cohort study design was used to collect data from 3 different institutions. Children and adolescents (below 19 y of age) who underwent PAO and were followed for minimum of 12 months were included. Obesity was defined as a body mass index ≥95 percentile. The modified Clavien-Dindo classification was used to grade complications. A logistic regression analysis was used to identify factors related to the development of a complication that required treatment outside of routine postoperative care (complication grades II to V). Changes in radiographic parameters including Tönnis acetabular roof angle, anterior center-edge angle, and lateral centeredge angle among obese versus nonobese subjects were also evaluated. Results: The mean age at surgery among the 84 adolescents included in the study was 16.5 years (range, 12 to 19 y). A total of 11% of the population was considered obese. Obesity (P=0.0047) was the only variable significantly associated with the development of a complication. After controlling for study site, the odds of an obese subject developing a complication were 10 [95% confidence interval (CI), 1.89-59.8] times the odds of a nonobese subject developing a complication. There was no difference in the magnitude of change in anterior center-edge angle (P=0.1251), lateral center-edge angle (P=0.9774), or Tönnis (P=0.5770) angular correction that was achieved among the obese versus nonobese subjects following surgery. Conclusions: The Bernese PAO allows for adequate radiographic correction of acetabular dysplasia among obese and nonobese adolescents. However, the hip preservation surgeon should be aware of the higher risk of complications among obese adolescents undergoing PAO for the treatment of symptomatic acetabular dysplasia.

AB - Background: The Bernese periacetabular osteotomy (PAO) is frequently used to treat symptomatic acetabular dysplasia in the adolescent age group. Despite encouraging results, factors predictive of the development of postoperative complications remain poorly understood. The purpose of this study was to investigate whether obesity is a risk factor for complications following PAO in adolescents. Methods: A retrospective cohort study design was used to collect data from 3 different institutions. Children and adolescents (below 19 y of age) who underwent PAO and were followed for minimum of 12 months were included. Obesity was defined as a body mass index ≥95 percentile. The modified Clavien-Dindo classification was used to grade complications. A logistic regression analysis was used to identify factors related to the development of a complication that required treatment outside of routine postoperative care (complication grades II to V). Changes in radiographic parameters including Tönnis acetabular roof angle, anterior center-edge angle, and lateral centeredge angle among obese versus nonobese subjects were also evaluated. Results: The mean age at surgery among the 84 adolescents included in the study was 16.5 years (range, 12 to 19 y). A total of 11% of the population was considered obese. Obesity (P=0.0047) was the only variable significantly associated with the development of a complication. After controlling for study site, the odds of an obese subject developing a complication were 10 [95% confidence interval (CI), 1.89-59.8] times the odds of a nonobese subject developing a complication. There was no difference in the magnitude of change in anterior center-edge angle (P=0.1251), lateral center-edge angle (P=0.9774), or Tönnis (P=0.5770) angular correction that was achieved among the obese versus nonobese subjects following surgery. Conclusions: The Bernese PAO allows for adequate radiographic correction of acetabular dysplasia among obese and nonobese adolescents. However, the hip preservation surgeon should be aware of the higher risk of complications among obese adolescents undergoing PAO for the treatment of symptomatic acetabular dysplasia.

KW - Acetabular dysplasia

KW - Adolescent hip

KW - Obesity

KW - Periacetabular osteotomy

KW - Postoperative complications

UR - http://www.scopus.com/inward/record.url?scp=84942610804&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84942610804&partnerID=8YFLogxK

M3 - Article

C2 - 25379824

AN - SCOPUS:84942610804

VL - 35

SP - 561

EP - 564

JO - Journal of Pediatric Orthopaedics

JF - Journal of Pediatric Orthopaedics

SN - 0271-6798

IS - 6

ER -