Summary

A systematic review reporting on patient-reported outcomes of combined hip arthroscopy and periacetabular osteotomy.

Abstract

Background

Despite several studies reporting outcomes of concomitant hip arthroscopy and periacetabular osteotomy (PAO), there is a paucity of aggregate data in the literature.

Purpose

The purpose of this study is to evaluate outcomes and survivorship of patients undergoing concomitant hip arthroscopy and PAO.

Methods

A systematic review was performed on the current literature with the following keywords: “periacetabular osteotomy,” “hip arthroscopy,” “combined,” “concomitant,” “concurrent,” “femoroacetabular impingement,” and “outcomes.” PubMed, Cochrane, and Scopus were queried in April 2022 using the criteria established in the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA). The following information was recorded for each study if available: title, author, publication date, study design, demographic, number of hips, follow-up time, study period, indications for hip arthroscopy, patient-reported outcomes (PROs), rates of secondary hip preservation surgeries, and rates of conversion to total hip arthroplasty (THA).

Results

Ten articles were included in the systematic review. Three studies were level III evidence, and seven studies were level IV evidence. This review included 553 hips with average follow-up that ranged from 1 to 12.8 years. The average age at time of surgery ranged from 20.4 to 40 years. Nine studies reported outcomes in the general population and one study reported on outcomes in the athletic population. All ten studies listed dysplasia as the surgical indication. Nine studies reported PROs and 7 studies reported significant improvements after surgery. Four studies reported additional clinical benefit thresholds and every study reported an 80% achievement of at least one psychometric threshold. Seven out of 10 studies reported surgery rates on either hip preservation or conversion to THA. Secondary hip preservation procedure rates ranged from 0% to 7% and conversion to THA rates ranged from 0% to 3.4%. Overall secondary surgery rates varied from 0% to 10.3%

Conclusion

Patients who underwent concomitant hip arthroscopy and PAO reported favorable outcomes and high rates of clinical benefit. However, there were variable rates of secondary hip preservation procedures and conversion to THA with higher revision rates demonstrated in athletes.