scholarly journals One stage hip arthroscopy and periacetabular osteotomy: surgical technique and initial results

2017 ◽  
Vol 5 (1_suppl) ◽  
pp. 2325967117S0001
Author(s):  
Gerardo Zanotti ◽  
Fernando Comba ◽  
Eduardo Genovesi ◽  
Martin Buttaro ◽  
Francisco Piccaluga
Keyword(s):  
Surgical Technique ◽  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Periacetabular Osteotomy ◽  
Combined Treatment ◽  
Radiographic Examination ◽  
Edge Angle ◽  
One Stage ◽  
Center Edge ◽  
Center Edge Angle

Aim: We purposed to describe the surgical technique and preliminary outcomes of combined arthroscopic and periacetabular osteotomy (PAO) for the treatment of non-arthritic hip dysplasia. Methods: Between May and August 2015, 4 patients (3 female, 1 male) with an average age of 29 years old (range; 22-33) had undergone one-stage hip arthroscopy and periacetabular osteotomy. Primary symptom was pain associated with instability. Upon radiographic examination, mean lateral center-edge angle of Wiberg was 12° (range; 7°-18°). Intra-articular findings were computed and primary outomes were as follows: radiographic angular correction; time to healing after pelvis osteotomy and functional results according to Merle D’Aubigné Score. Results: Minimum follow-up was 6 months whereas maximum was 9 months. Mean surgical time was 98 minutes for hip arthroscopy and 132 minutes for the osteotomy. In all cases, a lesion of the antero-superior labrum and the chondro-labral junction was found and repaired. After correction, overall postoperative center-edge angle was 29° (range; 25°-35°). Bone healing was certified in all cases at 6 months postoperatively. Overall Merle D’Aubigné Score was 17/18 points. Conclusion: Combined treatment of non-arthritic hip dysplasia with hip arthroscopy and PAO obtained good clinical and radiological outcomes. Former arthroscopy enables the diagnosis of cartilage lesions and intra-articular pathology as well as it aids in proceeding or not to an open correction.

scholarly journals Periacetabular osteotomy with concomitant hip arthroscopy: A case series with 24 months minimum follow-up

Medwave ◽  
2020 ◽  
Vol 20 (11) ◽  
pp. e8082-e8082
Author(s):  
Cristian Barrientos ◽  
Julián Brañes ◽  
Rodrigo Olivares ◽  
Rodrigo Wulf ◽  
Álvaro Martinez ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hip Arthroscopy ◽  
Periacetabular Osteotomy ◽  
Case Series ◽  
Resonance Imaging ◽  
Edge Angle ◽  
Center Edge ◽  
Lateral Center Edge Angle ◽  
Center Edge Angle

Purpose To describe patient-reported outcomes, radiological results, and revision to total hip replacement in patients with hip dysplasia that underwent periacetabular osteotomy as isolated treatment or concomitant with hip arthroscopy. Methods Case series study. Between 2014 and 2017, patients were included if they complained of hip pain and had a lateral center-edge angle ≤ of 20°. Exclusion criteria included an in-maturate skeleton, age of 40 or older, previous hip surgery, concomitant connective tissue related disease, and Tönnis osteoarthritis grade ≥ 1. All patients were studied before surgery with an anteroposterior pelvis radiograph, false-profile radiograph, and magnetic resonance imaging. Magnetic resonance imaging was used to assess intraarticular lesions, and if a labral or chondral injury was found, concomitant hip arthroscopy was performed. The non-parametric median test for paired data was used to compare radiological measures (anterior and lateral center-edge angle, Tönnis angle, and extrusion index) after and before surgery. Survival analysis was performed using revision to total hip arthroplasty as a failure. Kaplan Meier curve was estimated. The data were processed using Stata. Results A total of 15 consecutive patients were included; 14 (93%) were female patients. The median follow-up was 3.5 years (range, 2 to 8 years). The median age was 20 (range 13 to 32). Lateral center-edge angle, Tönnis angle, and extrusion index correction achieved statistical significance. Seven patients (47%) underwent concomitant hip arthroscopy; three of them (47%) were bilateral (10 hips). The labrum was repaired in six cases (60%). Three patients (15%) required revision with hip arthroplasty, and no hip arthroscopy-related complications are reported in this series. Conclusion To perform a hip arthroscopy concomitant with periacetabular osteotomy did not affect the acetabular correction. Nowadays, due to a lack of conclusive evidence, a case by case decision seems more appropriate to design a comprehensive treatment.

scholarly journals Is hip arthroscopy useful for the treatment of borderline dysplasia? A case-controlled study

2018 ◽  
Vol 6 (12_suppl5) ◽  
pp. 2325967118S0020
Author(s):  
José I Oñativia ◽  
Pablo Slullitel ◽  
Agustín García Mansilla ◽  
Fernando Díaz Dilernia ◽  
Martín Buttaro ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Multivariate Regression ◽  
Hip Dysplasia ◽  
Osteochondral Lesions ◽  
Edge Angle ◽  
Center Edge ◽  
Group 2 ◽  
Center Edge Angle ◽  
Group 1

Introduction: The idyllic treatment of hip dysplasia is periacetabular osteotomy (PAO). Since the indication of arthroscopy as a unique action is controversial in the treatment of dysplasia, our objective was to analyze its clinical and radiological results in a cohort of patients with borderline dysplasia and compare them with controls with femoroacetabular impingement (FAI). Material and methods: We retrospectively analyzed a group of 29 patients with a labral lesion secondary to borderline hip dysplasia (group 1) and another group of 197 patients with FAI (group 2) treated with hip arthroscopy, evaluating reoperations and joint survival as the main outcomes. Only patients with both diagnoses treated with hip arthroscopy and with a minimum follow-up of 2 years were included. We excluded patients with coxa profunda, patients who only underwent labral debridement, revisions, cases with dysplasia initially treated with PAO and those with previous ipsilateral hip pathology such as local neoplasia, avascular necrosis, Perthes disease or epiphysiolysis. The diagnosis of borderline dysplasia was made radiologically, with a lateral center-edge angle greater than 18° but less than 25°. Among patients of group 1, the arthroscopic capsulotomy was minimal (punctate) and the iliofemoral ligament was always respected; thus, capsular plicature was not performed in any case. The average follow-up was 43 months, being 41 months for group 1 and 43 months for group 2 (p=0.33). Although there was a greater proportion Tönnis 2 of degenerative changes among patients with FAI (10%) than in the group with borderline dysplasia (0.5%), this difference was not significant (p=0.14). Both groups presented with a high prevalence of CAM type lesion (88% of the series). However, the mean radiological alpha angle value was higher in group 1 (61°) than in group 2 (57°) (p=0.002). The Tönnis angle was categorized as normal (0-10°) in all patients with borderline dysplasia and in 71% of the FAI group, but in the rest of the latter group it was less than 0° (p<0.001). The average Wiberg angle was 22° in group 1 and 34° in those with FAI (p<0.001); while the average anterior center-edge angle was 23° in the first group and 30° in the second (p <0.001). We performed a multivariate regression analysis to associate the need of reoperation with different demographic, radiological and intraoperative variables. Results: There were 7 complications among patients of group 2: a superficial wound infection medically treated; 3 cases of paresthesias in pudendal territory that resolved spontaneously in all cases at 3 months postoperatively; 1 deep vein thrombosis and 2 cases of heterotopic calcifications in patients who remained asymptomatic. No complications were recorded in the borderline dysplasia group. Thirty-eight percent of the series presented with osteochondral lesions detected during the arthroscopy (p=0.69). Of these, 42% were treated with microfractures (p=0.21) because they were classified as Outerbridge grade 4. Five patients in group 2 required a new surgical procedure. In 2 of them, the reoperation consisted of a controlled dislocation due to the progression of the size of their osteochondral lesions at 21 and 48 months of the initial procedure. Both cases presented an Outerbridge 4 osteochondral lesion greater than 0.5 cm2 in the initial arthroscopy. The remaining 3 cases were treated with a revision arthroscopy due to the persistence of their symptoms at a mean of 22 months postoperatively, due to an insufficient osteochondroplasty done at the first procedure. However, the rate of joint preservation was 100% since at the end of follow-up none of the patients had to be converted to total hip replacement. Although there were no reoperations in the borderline dysplasia group, this difference with group 1 was not statistically significant (p=0.38). The multivariate regression model adjusted for reoperation showed a very strong statistical association between the finding of osteochondral lesions and therapeutic failure, with a coefficient of 0.12 (p<0.001, CI95% = 0.06 - 0.17). In the same way, although the association was weak (p=0.04, CI95% = -0.4 - -0.01), the fact of resecting the CAM lesion behaved as protector for the model with a coefficient of -0.2. Conclusion: Hip arthroscopy was useful in the treatment of borderline dysplasia, without showing survival differences with the FAI group. We suggest indicating it carefully in the dysplasia, whenever the symptoms of FAI prevail over those of instability.

scholarly journals BORDERLINE DYSPLASIA: ARE THESE HIPS ONLY MILDLY UNCOVERED?

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0013
Author(s):  
Michael McClincy ◽  
James Wylie ◽  
Yi-Meng Yen ◽  
Eduardo Novais
Keyword(s):  
Hip Arthroscopy ◽  
Periacetabular Osteotomy ◽  
Edge Angle ◽  
Radiographic Parameters ◽  
Center Edge ◽  
Hip Morphology ◽  
Acetabular Deficiency ◽  
Fear Index ◽  
Cam Morphology ◽  
Center Edge Angle

Background: Controversy surrounds classification and treatment of hips with a lateral center-edge angle (LCEA) between 18° and 25°. It remains undetermined as to whether open or arthroscopic procedures are best used to treat patients with borderline dysplasia. We hypothesized that patients with hip pain and borderline acetabular dysplasia have different features of acetabular morphology as determined by other relevant radiographic measures beyond the LCEA. Methods: A retrospective review of patients undergoing hip preservation surgery between January 2010 and December 2015 with either periacetabular osteotomy(PAO) or hip arthroscopy with a LCEA between 18° and 25° was performed. Anteroposterior, Dunn lateral and false profile radiographs were used to measure LCEA, Tönnis Angle, anterior center edge angle (ACEA), anterior (AWI) and posterior (PWI) wall indexes, the femoral epiphyseal acetabular roof (FEAR) index, joint space width, crossover sign, posterior wall sign, P/A index, and femoral alpha angle. An agglomerative hierarchical clustering analysis was then performed on the continuous radiographic variables to identify different subtypes of hip pathomorphology among this patient cohort. There were sex-specific trends in hip morphology. Therefore, we proceeded to perform separate cluster analyses for each sex. Results: Ninety-nine patients underwent surgery in the study period, 77 (78%) were female, and 81 (82%) of these had complete radiographic images for cluster analysis. Mean age was 22.6 years. Hip arthroscopy was performed in 41% of patients and periacetabular osteotomy was performed in 59% of patients. The ACEA (45%), FEAR Index (34%), and AWI (30%) were the most commonly abnormal radiographic parameters among all patients. In female patients, the ACEA (55%), FEAR Index (42%), and AWI (34%) were the most commonly abnormal radiographic parameters. In male patients, an insufficient PWI (48%) was the most common radiographic abnormality. For females, we identified three clusters representing different patterns of hip morphology: impingement morphology; lateral acetabular deficiency, and anterolateral acetabular deficiency (Table 1A). For males, we identified three clusters: postero-lateral acetabular deficiency with global cam morphology, postero-lateral acetabular deficiency with focal cam morphology, and lateral acetabular deficiency without cam morphology (Table 1B). Conclusions: A comprehensive evaluation of radiographic parameters in patients with LCEA 18-25° identifies sex-specific trends in hip morphology and shows a large proportion of dysplastic features among these patients. A thorough evaluation of all pelvic morphology, not just lateral coverage, should be considered when indicating these patients for hip preservation surgeries. Further studies are needed to investigate the outcomes of patients within each of the identified clusters to determine optimal treatment options for each group. [Table: see text][Table: see text]

scholarly journals LOW DOSE CT SCAN FOLLOWING PERIACETABULAR OSTEOTOMY: ASSESSMENT OF REDUCTION AND CORRELATION WITH RADIOGRAPHIC MEASURES

2020 ◽  
Vol 8 (4_suppl3) ◽  
pp. 2325967120S0021
Author(s):  
Clarabelle DeVries ◽  
Jeffrey J Nepple ◽  
Lucas Fowler ◽  
Sean Akers ◽  
Gail Pashos ◽  
...  
Keyword(s):  
Femoral Head ◽  
Normative Data ◽  
Low Dose ◽  
Periacetabular Osteotomy ◽  
Femoral Head Coverage ◽  
Edge Angle ◽  
Center Edge ◽  
Two Sectors ◽  
Posterior Sector ◽  
Center Edge Angle

Introduction: Periacetabular osteotomy (PAO) has become a favored treatment for symptomatic acetabular dysplasia worldwide. Nevertheless, the parameters for optimal correction to avoid residual instability or iatrogenic impingement have not been defined. Purpose: The purposes of this study were (1) to assess the ability of PAO to correct femoral head coverage to normal ranges as measured by 3D CT scan and (2) to determine if postoperative radiographic parameters of dysplasia are accurate markers of optimal acetabular correction. Methods: A total of 43 hips (in 38 patients, mean 27.7 years, 88.4% female) were enrolled in this prospective cohort study at minimum 1 year after PAO. Postoperative femoral head coverage was assessed via low-dose CT and compared to normative data of asymptomatic hips from the literature. Anterior (3:00-1:15), lateral (1:00-11:00), and posterior (11:25-9:00) sector coverage was defined by averaging the coverage at 15 minute increments in each zone. Postoperative radiographs were utilized to measure lateral center edge angle (LCEA), anterior wall index (AWI), posterior wall index (PWI), and anterior center edge angle (ACEA). Good correction for each sector was defined as coverage from 1 SD below mean to 2 SD above mean. Results: Postoperatively, the anterior sector was normalized in 84% of hips, lateral sector in 84% of hips, and posterior sector in 86% of hips. Sixty-seven percent of hips were corrected to normative range in all three sectors and 19% were corrected in two sectors (86% in at least two sectors). LCEA and PWI showed the highest correlation with lateral and posterior sector coverage with Pearson’s correlation coefficients of 0.67 and 0.71 (p < 0.001), respectively. Weaker correlations were found between anterior coverage and the AWI and ACEA coverage (-0.16 and 0.15, respectively). Good correction was best correlated with the following target values for acetabular correction: LCEA 28°, AI 1°, AWI 0.37, ACEA 32°, and PWI 1.0. Conclusion: PAO can effectively normalize femoral head coverage compared to normative data. Good correction of each sector coverage ranged from 84-86% of cases. The proposed set of radiographic parameter targets were found to be reliable markers of femoral head coverage.

Hip Distraction Without a Perineal Post: A Prospective Study of 1000 Hip Arthroscopy Cases

2017 ◽  
Vol 46 (3) ◽  
pp. 632-641 ◽  
Author(s):  
Omer Mei-Dan ◽  
Matthew J. Kraeutler ◽  
Tigran Garabekyan ◽  
Jesse A. Goodrich ◽  
David A. Young
Keyword(s):  
Soft Tissue ◽  
Hip Arthroscopy ◽  
Case Series ◽  
Edge Angle ◽  
Center Edge ◽  
Hip Distraction ◽  
The Mean ◽  
Distraction Force ◽  
Lateral Center Edge Angle ◽  
Center Edge Angle

Background: Hip arthroscopy has traditionally been performed with a perineal post, resulting in various groin-related complications, including pudendal nerve neurapraxias, vaginal tears, and scrotal necrosis. Purpose: To assess the safety of a technique for hip distraction without the use of a perineal post. Study Design: Case series; Level of evidence, 4. Methods: We prospectively analyzed a consecutive cohort of 1000 hips presenting to a dedicated hip preservation clinic; all patients had hip pain and were subsequently treated with hip arthroscopy. Demographic variables, hip pathology, and lateral center edge angle were recorded for each case. In the operating room, the patient’s feet were placed in traction boots in a specifically designed distraction setup, and the operative table was placed in varying degrees of Trendelenburg. With this technique, enough resistance is created by gravity and friction between the patient’s body and the bed to allow for successful hip distraction without the need for a perineal post. In a subset of 309 hips (n = 281 patients), the degrees of Trendelenburg as well as the distraction force were analyzed. Results: The mean ± SD Trendelenburg angle used among the subset of 309 hips was 11° ± 2°. The mean initial distraction force necessary was 90 ± 28 lb, which decreased to 65 ± 24 lb by 30 minutes after traction initiation ( P < .0001). The most important variables in determining initial force for this cohort of patients were, in order of magnitude, sex ( P < .0001), weight ( P < .0001), and lateral center edge angle ( P < .01). No groin-related complications occurred among the entire cohort of patients, including soft tissue or nerve-related complications. The rate of deep venous thrombosis was 2 in 1000. Conclusion: The use of the Trendelenburg position and a specially designed distraction setup during hip arthroscopy allows for safe hip distraction without a perineal post, thereby eliminating groin-related soft tissue and nerve complications. Certain patient variables can be used to estimate the required distraction force and inclination angle with this method.

scholarly journals Superior Clinical Outcomes with Capsular Closure versus Non-Closure in Patients Undergoing Arthroscopic Hip Labral Repair

2018 ◽  
Vol 6 (3_suppl) ◽  
pp. 2325967118S0000 ◽  
Author(s):  
Ioanna Bolia ◽  
Karen K. Briggs ◽  
Marc J. Philippon
Keyword(s):  
Clinical Outcomes ◽  
Hip Arthroscopy ◽  
Labral Repair ◽  
Secondary Outcome ◽  
Edge Angle ◽  
Center Edge ◽  
Lateral Center Edge Angle ◽  
Closure Group ◽  
Center Edge Angle

Objectives: Controversy still exists on closing the capsule following hip arthroscopy. It is unclear if capsular closure at the end of hip arthroscopy results in better clinical outcomes compared to non-closure. The purpose of this study was to compare the clinical outcomes in patients who had a closed capsule to those without a closed capsule following hip arthroscopic labral repair by a single surgeon. Methods: Patients who did not have capsular closure were identified by reviewing arthroscopy video (non-closure group). Fifty consecutive patients without capsular closure were matched with fifty patients who had capsular closure. All patients underwent primary hip arthroscopy and labral repair. The primary patient-reported outcome measure was Hip Outcome Score(HOS)-ADL. Secondary outcome measures included the modified Harris hip score(MHHS), HOS-Sport, WOMAC, general health, and patient satisfaction with outcome. Patients with lateral center edge angle less than 25º were excluded. Results: There were 23 females and 27 males with an average age of 36 years (range:14 to 77) in each group. The average lateral center edge angle was 34º (range, 27 to 48) in both groups. The alpha angle was 68º (range, 40 to 134) in the non-closure group and 70º (range, 41 to 98) in the closure group. No patient had microfractures at the time of surgery. The average follow-up time was 5 years (non-closure group range: 3-10; closure group range 3-9). Eight patients (16%) in the non-closure group required total hip arthroplasty(THA), while 4 patients (8%) in the closure group required THA. Six patients in the non-closure group and 3 patients in the closure group required revision hip arthroscopy. Of those patients who did not require revision or THA, there was a significant difference in the HOS ADL score and the secondary outcome measures (see table). Capsular closure resulted in superior clinical outcomes compared to non-closure. Conclusion: There were twice as many conversion to THA and twice as many hip arthroscopy revisions in patients undergoing hip arthroscopic labral repair without capsular closure compared to those with closure. In addition, the closure group showed significantly higher outcomes scores compared to the non-closure at 5-year follow-up time. [Table: see text]

scholarly journals Is Hip Arthroscopy Effective in Patients With Combined Excessive Femoral Anteversion and Borderline Dysplasia? A Match-Controlled Study

2018 ◽  
Vol 47 (1) ◽  
pp. 123-130 ◽  
Author(s):  
Edwin O. Chaharbakhshi ◽  
David E. Hartigan ◽  
Itay Perets ◽  
Benjamin G. Domb
Keyword(s):  
Hip Arthroscopy ◽  
Femoral Anteversion ◽  
Harris Hip Score ◽  
Control Group ◽  
Edge Angle ◽  
Center Edge ◽  
Modified Harris Hip Score ◽  
Lateral Center Edge Angle ◽  
Center Edge Angle

Background: Appropriate patient selection is critical when hip arthroscopy is considered in the setting of borderline dysplasia (BD). It is presumable that excessive femoral anteversion (EFA) and BD may contraindicate arthroscopy. Hypothesis: Patients with combined EFA and BD (EFABD) demonstrate significantly inferior short-term outcomes after arthroscopic labral preservation and capsular closure when compared with a similar control group with normal lateral coverage and femoral anteversion. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected and retrospectively reviewed on patients undergoing hip arthroscopy between April 2010 and November 2014. The EFABD group’s inclusion criteria were BD (lateral center-edge angle, 18°-25°), labral tear, capsular closure, and femoral version ≥20°, as well as preoperative modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, and visual analog scale. Exclusion criteria were workers’ compensation, preoperative Tönnis grade >1, microfracture, abductor pathology, or previous ipsilateral hip surgery or conditions. Patients in the EFABD group were matched 1:2 to a similar control group with normal coverage and femoral anteversion by age at surgery ± 6 years, sex, body mass index ± 5, acetabular Outerbridge grade (0, 1 vs 2, 3, 4), and iliopsoas fractional lengthening. Results: Sixteen EFABD cases were eligible for inclusion, and 100% follow-up was obtained at ≥2 years postoperatively. Twelve EFABD cases were matched to 24 control cases. Mean femoral version was 22.4° in the EFABD group and 10.2° in the control group ( P = .01). Mean lateral center-edge angle was 22.1° in the EFABD group and 31.5° in the control group ( P < .0001). Acetabuloplasty was performed significantly more frequently in the control group ( P = .0006). No other significant differences were found regarding demographics, findings, procedures, or preoperative scores. At latest follow-up, the EFABD group demonstrated significantly lower mean modified Harris Hip Score (76.1 vs 85.9; P = .005), Nonarthritic Hip Score (74.8 vs 88.5; P < .0001), Hip Outcome Score–Sports Specific Subscale (58.3 vs 78.4; P = .02), and patient satisfaction (7.1 vs 8.3; P = .005). There were 4 secondary surgical procedures (33.3%) in the EFABD group and 1 (4.2%) in the control group ( P = .03). One patient in each group required arthroplasty. Conclusion: Patients treated with arthroscopic labral preservation and capsular closure in the setting of EFABD demonstrated significant improvements from presurgery to latest follow-up. However, their results are significantly inferior when compared with a matched-controlled group. Consideration of periacetabular osteotomy or femoral osteotomy may be warranted in the setting of EFABD to achieve optimal benefit.

scholarly journals Concomitant Hip Arthroscopy and Periacetabular Osteotomy: Is there a Difference in Perioperative Complications compared with Periacetabular Osteotomy Alone?

2017 ◽  
Vol 7 (1) ◽  
pp. 51-57
Author(s):  
Steven A Olson ◽  
Julie A Neumann ◽  
Kathleen D Rickert ◽  
Brian D Lewis ◽  
Kendall E Bradley ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Hip Dysplasia ◽  
Operative Time ◽  
Perioperative Complications ◽  
Periacetabular Osteotomy ◽  
Wound Complications ◽  
Complication Rates ◽  
Center Edge ◽  
Estimated Blood Loss ◽  
Articular Pathology

ABSTRACT Purpose To evaluate the safety of hip arthroscopy combined with a periacetabular osteotomy (PAO) compared with PAO alone in treating concomitant intra-articular pathology in hip dysplasia. Materials and methods Forty-one patients (46 hips) with symptomatic hip dysplasia were retrospectively reviewed. Pre- and postoperative radiographic data and intraoperative data consisting of estimated blood loss, intraoperative and postoperative blood transfusions, operative time, and length of hospital stay were recorded. The complications occurring within the first 3 months after surgery including lateral femoral cutaneous and pudendal nerve neuropraxia, wound complications, and reoperations were recorded. Additionally, rates of deep venous thrombosis and other major adverse outcomes (myocardial infarction, pulmonary embolism, stroke, death) were examined. Results Twenty-one patients (24 hips) underwent PAO alone. Twenty patients (22 hips) underwent hip arthroscopy followed immediately by PAO. There were no significant differences in the 90-day complication rates between the two groups, comparing the rate of neuropraxia (p = 0.155) and wound complications (p = 0.6). Operative time for PAO alone was 179 minutes (standard deviation [SD] ± 37) compared with 251 minutes (SD ± 52) for combined hip arthroscopy and PAO (p < 0.001). No incidence of deep vein thrombosis or major adverse events was noted in either group. Preoperative lateral center edge angle (LCEA) and acetabular index (AI) were 14° and 20° respectively, in the PAO-alone group and 19° and 16° respectively, in the combined group. Postoperatively, LCEA was 29° in the PAO-alone group and 30° in the combined group. Postoperative AI was 11° in the PAO-alone group and 5° in the combined group. Conclusion This study demonstrates that hip arthroscopy in combination with PAO to treat intra-articular pathology shows no difference in 90-day complication rates when compared with PAO alone. Level of evidence Level III, retrospective comparative study How to cite this article Neumann JA, Rickert KD, Bradley KE, Lewis BD, France MA, Olson SA. Concomitant Hip Arthroscopy and Periacetabular Osteotomy: Is there a Difference in Perioperative Complications compared with Periacetabular Osteotomy Alone? The Duke Orthop J 2017;7(1):51-57.

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