| Abstract [eng] |
1. ABSTRACT Introduction PAO is the gold standard surgical treatment for improving insufficient femoral head coverage in patients with DDH and aiming to achieve hip stability. The surgery stands as an intervention for improving the quality of life and prolonging the time until a THA is needed in patients suffering from debilitating hip joint instability. However, there is limited data on factors influencing the accuracy of postoperative correction, especially under- and overcorrection of the LCEA. Methods This retrospective study analyzes the data of 62 hips treated with PAO at the RVUL hospital in Vilnius, Lithuania. Pre- and postoperative AP pelvic X-rays were evaluated, focusing on the LCEA, also known as Wiberg angle. The primary objective was to assess whether lower preoperative LCEA values are significantly associated with increased odds for surgical undercorrection, set as LCEA <25°. H0 = Lower preoperative LCEA values are not significantly associated with increased odds for undercorrection. Secondary objectives were to investigate for the influence of additional factors like patient age and sex on the risk of surgical undercorrection. Furthermore, another aim was to examine which proportions of patients reach sufficient femoral head coverage within the defined ranges for adequate, defined as between 25° and 40°, and optimal coverage, designated as between 30° and 40°. Written informed consent was obtained from all patients for the use of their anonymized data (X-rays, age, and sex); the consent forms are held by the supervisor. Results Lower preoperative LCEA values were significantly associated with increased odds of undercorrection (OR 0.875, p < 0.01). No significant association was found between patient age or sex and undercorrection. PAO effectively reduced variability in LCEA, shifting values into the physiologic target range. Undercorrection and overcorrection occurred at comparable rates (approximately 12% each). 75.8% of hips were corrected to the adequate target range of 25° to 40°, of which 80.9% reached the optimal target range between 30° and 40°. Conclusion Lower preoperative LCEA were found to be a key predictor of postoperative acetabular undercorrection following PAO. This finding highlights the importance of precise assessment, treatment planning, and intraoperative execution, particularly in patients with severe dysplasia. |
