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Clin Orthop Relat Res. 2011 Feb;469(2):447-53. doi: 10.1007/s11999-010-1544-9.

Bernese periacetabular osteotomy in males: is there an increased risk of femoroacetabular impingement (FAI) after Bernese periacetabular osteotomy?

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  • 1Department of Orthopaedic Surgery, Universit√§tsklinik Inselspital, University of Berne, Berne, Switzerland.

Abstract

BACKGROUND:

The Bernese periacetabular osteotomy (PAO) is a popular option for treating symptomatic acetabular dysplasia. We noted symptomatic impingement after PAO in several male patients.

QUESTIONS/PURPOSES:

We therefore determined (1) the incidence of clinical signs of FAI after PAO in the male population; and (2) whether any factors were associated with the positive impingement signs after PAO in males.

PATIENTS AND METHODS:

We retrospectively reviewed 38 males who underwent 46 periacetabular osteotomies (PAO) between 2000 and 2007. Clinical and radiographic data were analyzed with the focus on pre- and postoperative incidence of femoroacetabular impingement. Minimum followup was 12 months (average, 43 months; range, 12-90 months).

RESULTS:

We found a positive impingement sign in 19 of the 46 hips during the preoperative examination compared to 22 (47.8%) hips postoperatively. The ROM (flexion and internal rotation) decreased postoperatively compared to preoperatively. Radiographic parameters of coverage LCE-, ACE- and Tönnis angle improved into the normal range. Twenty hips had postoperative heterotopic ossification to varying degrees, mostly minor. WOMAC scores improved in the function and pain domains postoperatively.

CONCLUSIONS:

Despite normalization of coverage we found a high postoperative rate of clinical signs of FAI after PAO in males.

LEVEL OF EVIDENCE:

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.

PMID:
20848246
[PubMed - indexed for MEDLINE]
PMCID:
PMC3018207
Free PMC Article
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