Factors predicting the outcomes of incomplete triple pelvic osteotomy

Abstract

Introduction: In the present study, we identified factors affecting the outcomes of patients who underwent incomplete triple pelvic osteotomies due to acetabular dysplasia. Methods: Data on a total of 58 hips in 50 patients for whom adequate data were available and who had undergone appropriate follow-up were retrospectively evaluated. We used Omeroglu scores for radiological evaluation, Harris Hip Scores for clinical evaluation, Tonnis scores to evaluate osteoarthritis progression and a modified Clavien-Dindo classification to evaluate complications. Results: The average patient age was 23.26 (14-47) years, and the average follow-up duration 105.59 (18-191) months. The complication rate was 10.3%, and complications negatively influenced clinical outcomes. Patients with radiologically poorer outcomes had more advanced osteoarthritis. We found minimal improvements in lateral centre edge angle (LCEA), refined centre-edge angle (RCEA), and lateral acetabulum head index (LAHI) were associated with osteoarthritis progression and that good improvements in LCEA, RCEA, acetabular angle (AA), and LAHI were associated with radiological outcomes. Neither patient age at the time of operation nor development of a postoperative relative crossover sign affected osteoarthritis progression or clinical or radiological outcomes. Conclusions: The most important factors influencing clinical outcomes were complications. However, neither postoperative acetabular retroversion nor a positive supra-equatorial crossover sign (often viewed as prognostically negative) directly affected clinical outcomes. When treating patients with acetabular dysplasia, either inadequate correction or overcorrection may negatively affect outcomes. In such patients, an incomplete triple pelvic osteotomy (allowing controlled correction) is both safe and effective.