Joint congruency in abduction before surgery as an indication for rotational acetabular osteotomy in early hip osteoarthritis

We conducted a retrospective review of the results of rotational acetabular osteotomy (RAO) procedures in 92 hips of 89 patients (81 females and eight males) with early-stage osteoarthritis. In this study, we discuss the indications for this surgery based on the preoperative congruency in abduction. The mean postoperative follow-up was 12.2 (7–19) years. The mean age at operation was 32.5 (13–54) years. Two hips with apparent technical failure were excluded. During follow-up, the osteoarthritic stage remained unchanged in 76 hips (good group) and progressed in 14 hips (poor group). Preoperative joint congruency in abduction was excellent in 20 hips, good in 62, and fair in eight. All eight hips with fair joint congruency showed progression to osteoarthritis at follow-up. Patients without good congruency in abduction may experience progression of osteoarthritis after RAO procedures even in early-stage osteoarthritis.ResuméNous avons réalisé une étude rétrospective des résultats de l’ostéotomie acétabulaire (RAO) sur 92 hanches chez 89 patients (81 femmes et 8 hommes). Ces patients présentaient une arthrose précoce de hanche. Nous avons discuté dans cette étude les indications de la chirurgie basée notamment sur la congruence préopératoire en abduction de l’articulation. Le suivi moyen postopératoire a été de 12,2 ans (de 7 à 19 ans). L’âge moyen d’intervention de 32,5 ans (de 13 à 54 ans). 2 hanches présentaient un défaut technique et ont été exclues de l’étude. Durant le suivi, l’arthrose n’a pas évolué sur 76 hanches (groupe bon) et a progressé dans 14 hanches (groupe mauvais). La congruence préopératoire de l’articulation de la hanche en abduction était excellente dans 20 hanches, bonne dans 62 et médiocre dans 8 hanches. Les 8 hanches présentant une congruence médiocre ont montré en préopératoire une progression de l’arthrose tout au long du suivi. En conclusion, les patients avec une bonne congruence en abduction ont profité de l’ostéotomie de rotation acétabulaire y compris quand il existe une arthrose précoce.

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