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Published in: Clinical Orthopaedics and Related Research® 3/2013

01-03-2013 | Clinical Research

Physical Activity Level Improves After Periacetabular Osteotomy for the Treatment of Symptomatic Hip Dysplasia

Authors: Eduardo N. Novais, MD, Benton Heyworth, MD, Kerri Murray, MPH, Victor M. Johnson, MA, Young-Jo Kim, MD, PhD, Michael B. Millis, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 3/2013

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Abstract

Background

Hip pain secondary to acetabular dysplasia can prevent participation in recreational activities.

Questions/Purposes

We retrospectively evaluated the physical activity level and pain after periacetabular osteotomy (PAO) for the treatment of symptomatic hip dysplasia.

Methods

Forty-seven female and four male patients with a mean age of 27 years underwent a PAO. Physical activity (UCLA) and pain (WOMAC) were assessed preoperatively, at 1 year, and at minimum 2 years postoperatively. Multivariable linear regression identified substantial, independent factors associated with postoperative activity level.

Results

The UCLA activity scores were on average higher at 1 year and remained higher at minimum 2 years when compared with preoperative scores. Mean postoperative WOMAC pain scores assessed at 1 year and at least 2 years were lower than mean preoperative scores. Age and preoperative physical activity level were strong independent predictors for activity level at 1 year and at minimum 2 years after surgery. Postoperative pain level was a moderate predictor for the level of activity at minimum 2-year followup.

Conclusions

Physical activity level improves after PAO. Younger age and higher activity levels before surgery and lower level of pain after surgery are predictive factors for postoperative level of activity in the short term. The data presented here may be useful to counsel the active young adult with symptomatic hip dysplasia about the improvement of level of activity to be expected after PAO.

Level of Evidence

Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Literature
1.
go back to reference American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975–991.CrossRef American College of Sports Medicine Position Stand. The recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness, and flexibility in healthy adults. Med Sci Sports Exerc. 1998;30:975–991.CrossRef
2.
go back to reference Amstutz HC, Thomas BJ, Jinnah R, Kim W, Grogan T, Yale C. Treatment of primary osteoarthritis of the hip: a comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am. 1984;66:228–241.PubMed Amstutz HC, Thomas BJ, Jinnah R, Kim W, Grogan T, Yale C. Treatment of primary osteoarthritis of the hip: a comparison of total joint and surface replacement arthroplasty. J Bone Joint Surg Am. 1984;66:228–241.PubMed
3.
go back to reference Bellamy N, Buchanan WW. A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee. Clin Rheumatol. 1986;5:231–241.PubMedCrossRef Bellamy N, Buchanan WW. A preliminary evaluation of the dimensionality and clinical importance of pain and disability in osteoarthritis of the hip and knee. Clin Rheumatol. 1986;5:231–241.PubMedCrossRef
4.
go back to reference Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.PubMed
5.
go back to reference Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW. Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res. 2009;467:2041–2052.PubMedCrossRef Clohisy JC, Schutz AL, St John L, Schoenecker PL, Wright RW. Periacetabular osteotomy: a systematic literature review. Clin Orthop Relat Res. 2009;467:2041–2052.PubMedCrossRef
6.
go back to reference D’Aubigne RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36:451–475.PubMed D’Aubigne RM, Postel M. Functional results of hip arthroplasty with acrylic prosthesis. J Bone Joint Surg Am. 1954;36:451–475.PubMed
7.
go back to reference Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, Lakatta EG. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112:674–682.PubMedCrossRef Fleg JL, Morrell CH, Bos AG, Brant LJ, Talbot LA, Wright JG, Lakatta EG. Accelerated longitudinal decline of aerobic capacity in healthy older adults. Circulation. 2005;112:674–682.PubMedCrossRef
8.
go back to reference Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop Relat Res. 1988;232:26–36.PubMed Ganz R, Klaue K, Vinh TS, Mast JW. A new periacetabular osteotomy for the treatment of hip dysplasias: technique and preliminary results. Clin Orthop Relat Res. 1988;232:26–36.PubMed
9.
go back to reference Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed Harris WH. Traumatic arthritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty: an end-result study using a new method of result evaluation. J Bone Joint Surg Am. 1969;51:737–755.PubMed
10.
go back to reference Katz MH. Multivariable Analysis: A Practical Guide for Clinicians and Public Health Researchers. New York, NY, USA: Cambridge University Press; 2011.CrossRef Katz MH. Multivariable Analysis: A Practical Guide for Clinicians and Public Health Researchers. New York, NY, USA: Cambridge University Press; 2011.CrossRef
11.
go back to reference Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991;73:423–429.PubMed Klaue K, Durnin CW, Ganz R. The acetabular rim syndrome: a clinical presentation of dysplasia of the hip. J Bone Joint Surg Br. 1991;73:423–429.PubMed
12.
go back to reference Lequesne M, de Sèze S. [False profile of the pelvis: a new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies] [in French]. Rev Rhum Mal Osteoartic. 1961;28:643–652.PubMed Lequesne M, de Sèze S. [False profile of the pelvis: a new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies] [in French]. Rev Rhum Mal Osteoartic. 1961;28:643–652.PubMed
13.
go back to reference Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am. 2009;91:2113–2123.PubMedCrossRef Matheney T, Kim YJ, Zurakowski D, Matero C, Millis M. Intermediate to long-term results following the Bernese periacetabular osteotomy and predictors of clinical outcome. J Bone Joint Surg Am. 2009;91:2113–2123.PubMedCrossRef
14.
go back to reference Naal FD, Impellizzeri FM, Leunig M. Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res. 2009;467:958–965.PubMedCrossRef Naal FD, Impellizzeri FM, Leunig M. Which is the best activity rating scale for patients undergoing total joint arthroplasty? Clin Orthop Relat Res. 2009;467:958–965.PubMedCrossRef
15.
go back to reference Sallis JF, Owen N. Physical Activity & Behavioral Medicine. Thousand Oaks, CA, USA: Sage; 1998. Sallis JF, Owen N. Physical Activity & Behavioral Medicine. Thousand Oaks, CA, USA: Sage; 1998.
16.
go back to reference Sink EL, Beaule PE, Sucato D, Kim YJ, Millis MB, Dayton M, Trousdale RT, Sierra RJ, Zaltz I, Schoenecker P, Monreal A, Clohisy J. Multicenter study of complications following surgical dislocation of the hip. J Bone Joint Surg Am. 2011;93:1132–1136.PubMedCrossRef Sink EL, Beaule PE, Sucato D, Kim YJ, Millis MB, Dayton M, Trousdale RT, Sierra RJ, Zaltz I, Schoenecker P, Monreal A, Clohisy J. Multicenter study of complications following surgical dislocation of the hip. J Bone Joint Surg Am. 2011;93:1132–1136.PubMedCrossRef
17.
go back to reference Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.PubMedCrossRef Steppacher SD, Tannast M, Ganz R, Siebenrock KA. Mean 20-year followup of Bernese periacetabular osteotomy. Clin Orthop Relat Res. 2008;466:1633–1644.PubMedCrossRef
18.
go back to reference Surgeon General’s report on physical activity and health. From the Centers for Disease Control and Prevention. JAMA. 1996;276:522. Surgeon General’s report on physical activity and health. From the Centers for Disease Control and Prevention. JAMA. 1996;276:522.
19.
go back to reference Tönnis D. General radiograph of the hip joint. In: Tönnis D, ed. Congenital Dysplasia, Dislocation of the Hip. New York, NY, USA: Springer; 1987:100–142.CrossRef Tönnis D. General radiograph of the hip joint. In: Tönnis D, ed. Congenital Dysplasia, Dislocation of the Hip. New York, NY, USA: Springer; 1987:100–142.CrossRef
20.
go back to reference Troelsen A, Elmengaard B, Soballe K. Medium-term outcome of periacetabular osteotomy and predictors of conversion to total hip replacement. J Bone Joint Surg Am. 2009;91:2169–2179.PubMedCrossRef Troelsen A, Elmengaard B, Soballe K. Medium-term outcome of periacetabular osteotomy and predictors of conversion to total hip replacement. J Bone Joint Surg Am. 2009;91:2169–2179.PubMedCrossRef
21.
go back to reference van Bergayk AB, Garbuz DS. Quality of life and sports-specific outcomes after Bernese periacetabular osteotomy. J Bone Joint Surg Br. 2002;84:339–343.PubMedCrossRef van Bergayk AB, Garbuz DS. Quality of life and sports-specific outcomes after Bernese periacetabular osteotomy. J Bone Joint Surg Br. 2002;84:339–343.PubMedCrossRef
22.
go back to reference Wagenmakers R, Stevens M, van den Akker-Scheek I, Zijlstra W, Groothoff JW. Predictive value of the Western Ontario and McMaster Universities Osteoarthritis Index for the amount of physical activity after total hip arthroplasty. Phys Ther. 2008;88:211–218.PubMedCrossRef Wagenmakers R, Stevens M, van den Akker-Scheek I, Zijlstra W, Groothoff JW. Predictive value of the Western Ontario and McMaster Universities Osteoarthritis Index for the amount of physical activity after total hip arthroplasty. Phys Ther. 2008;88:211–218.PubMedCrossRef
23.
go back to reference Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Acta Chir Scand. 1939;83:28–38. Wiberg G. Studies on dysplastic acetabula and congenital subluxation of the hip joint. With special reference to the complication of osteoarthritis. Acta Chir Scand. 1939;83:28–38.
24.
go back to reference Wright JG, Rudicel S, Feinstein AR. Ask patients what they want: evaluation of individual complaints before total hip replacement. J Bone Joint Surg Br. 1994;76:229–234.PubMed Wright JG, Rudicel S, Feinstein AR. Ask patients what they want: evaluation of individual complaints before total hip replacement. J Bone Joint Surg Br. 1994;76:229–234.PubMed
25.
go back to reference Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC. Assessing activity in joint replacement patients. J Arthroplasty. 1998;13:890–895.PubMedCrossRef Zahiri CA, Schmalzried TP, Szuszczewicz ES, Amstutz HC. Assessing activity in joint replacement patients. J Arthroplasty. 1998;13:890–895.PubMedCrossRef
Metadata
Title
Physical Activity Level Improves After Periacetabular Osteotomy for the Treatment of Symptomatic Hip Dysplasia
Authors
Eduardo N. Novais, MD
Benton Heyworth, MD
Kerri Murray, MPH
Victor M. Johnson, MA
Young-Jo Kim, MD, PhD
Michael B. Millis, MD
Publication date
01-03-2013
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 3/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2578-y

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