The Journal of Bone and Joint Surgery (American). 2006;88:1920-1926.
doi:10.2106/JBJS.E.00515
© 2006 The Journal of Bone and Joint Surgery, Inc.
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow [Supplementary Material]
Right arrow Letters to the Editor: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when Letters to the Editor are posted
Right arrow Alert me if a correction is posted
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowReprints and Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Peters, C. L.
Right arrow Articles by Hines, J. L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Peters, C. L.
Right arrow Articles by Hines, J. L.
Related Collections
Right arrow Adult Hip
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Technorati  
What's this?

Early Results of the Bernese Periacetabular Osteotomy: The Learning Curve at an Academic Medical Center

Christopher L. Peters, MD1, Jill A. Erickson, PA-C1 and Jerod L. Hines, MS1

1 Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108. E-mail address for C.L. Peters: Chris.Peters{at}hsc.utah.edu

Investigation performed at the Department of Orthopaedics, University of Utah, Salt Lake City, Utah

A commentary is available with the electronic versions of this article, on our web site (www.jbjs.org) and on our quarterly CD-ROM (call our subscription department, at 781-449-9780, to order the CD-ROM).

The authors did not receive grants or outside funding in support of their research for or preparation of this manuscript. They did not receive payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. No commercial entity paid or directed, or agreed to pay or direct, any benefits to any research fund, foundation, educational institution, or other charitable or nonprofit organization with which the authors are affiliated or associated.

Background: Most reports on the results of the Bernese periacetabular osteotomy for the treatment of developmental dysplasia of the hip have been by the originators of the procedure. In 1997, we began to use this osteotomy without direct training from the originators of the procedure.

Methods: Seventy-three patients (eighty-three hips) underwent a Bernese periacetabular osteotomy between 1997 and 2003 and were followed prospectively with use of the Harris hip score to assess clinical results and with use of anteroposterior pelvic and false-profile lateral plain radiographs to assess radiographic results. The three-dimensional position of the acetabulum was recorded preoperatively and postoperatively. The mean duration of follow-up was forty-six months.

Results: The average Harris hip score improved from 54 to 87 points (p < 0.001). Three hips (three patients) had a conversion to total hip arthroplasty at two, three, and four years after the periacetabular osteotomy. Preoperatively, fifty-four of the eighty-three acetabula were anteverted, and twenty-nine were either retroverted or had neutral wall relationships. Postoperatively, sixty-five hips (78%) were anteverted. Radiographically, in preoperatively anteverted hips, the average center-edge angle improved from 3° to 29° (p < 0.0001), the average anterior center-edge angle improved from 5° to 31° (p < 0.0001), and the acetabular index improved from 25° to 5° (p < 0.0001). In preoperatively retroverted or neutral hips, the average center-edge angle improved from 13° to 33° (p < 0.0001), the average anterior center-edge angle improved from 15° to 36° (p < 0.0001), and the acetabular index improved from 19° to 2° (p < 0.0001). Complications included four hematomas, three transient femoral nerve palsies, two deep wound infections, and one transient sciatic nerve palsy. Nine of the ten major complications and all four of the failed osteotomies occurred in the first thirty hips in which the index procedure was performed.

Conclusions: In our experience, the early results of the Bernese periacetabular osteotomy have been encouraging, with a 92% survival rate at thirty-six months. The occurrence of complications demonstrates a substantial learning curve. Recognition of the true preoperative acetabular version and reorientation of the acetabulum into an appropriately anteverted position have become important factors in surgical decision-making.

Level of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Technorati Technorati    What's this?


This article has been cited by other articles:


Home page
 JBJSHome page
E. Sharifi, H. Sharifi, S. Morshed, K. Bozic, and M. Diab
Cost-Effectiveness Analysis of Periacetabular Osteotomy
J. Bone Joint Surg. Am., July 1, 2008; 90(7): 1447 - 1456.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
A. Troelsen, B. Elmengaard, and K. Soballe
A New Minimally Invasive Transsartorial Approach for Periacetabular Osteotomy
J. Bone Joint Surg. Am., March 1, 2008; 90(3): 493 - 498.
[Abstract] [Full Text] [PDF]

Home page
 JBJSHome page
C. L. Peters and J. Erickson
The Etiology and Treatment of Hip Pain in the Young Adult
J. Bone Joint Surg. Am., December 1, 2006; 88(suppl_4): 20 - 26.
[Full Text] [PDF]