gms | German Medical Science

Objectives: Patients undergoing periacetabular osteotomy for symptomatic developmental dysplasia of the hip are usually young and active with high functional demands. Patients who participated in sports before PAO wish to remain active after surgery. There is little evidence regarding the level of activity that patients can achieve and the extent to which sporting activity changes both quantitatively and qualitatively after PAO. Therefore, the objective of the work presented was to determine the 1) change in activity level as measured by the UCLA activity index 2) changes in activity pattern and sports played 3) time to return to sports activities after PAO 4) subjective influence of PAO on athletic ability.

Methods: We conducted a retrospective analysis of prospectively collected data from our PAO database at a University Center. A total number of 123 patients who had undergone PAO at our institution between 01/2014 and 03/2018 and provided information on preoperative and postoperative activity levels and sports participation at follow-up were enrolled. Of the participating patients, 85% were female and 15% were male. The mean age of the patients in the study at the time of surgery was 27.74 years (SD: 7.34; range: 15-48 years). The mean follow-up time was 63 ± 10 months.

UCLA activity index, Hip function as measured by iHOT-12 and Subjective Hip Value as well as practiced sports, frequency and duration were assessed. Time to return to sports was also assessed. The subjective effect of PAO on athletic activity as well as eventual changes in practiced sports and reasons for those changes were recorded.

Results: UCLA activity index improved significantly from preoperative (5.08 ± 2.44) to postoperative (6.95 ± 1.74; p= <0.001).

The iHot-12 improved significantly from preoperatively (4.13 ± 2.21) to postoperatively (7.25 ± 2.29; p=<0.001). Subjective Hip Value also improved significantly from preoperatively (42.82 ± 24.34) to postoperatively (80.35 ± 17.75; p=<0.001).

Significantly more patients participated in low-impact sports postoperatively (p=0.0011). Participation in high-impact sports decreased postoperatively however the difference was not significant (p=0.36). The number of patients not practicing sports at all decreased significantly after PAO (p=0.0075).

Sports frequency in times per week (p=<0.0001) and length of exercise per week in minutes (p=0.007) also increased significantly. Most patients returned to sports after 6 months (42%) or 1-3 month (38%).

The majority of patients (58.12%) reported that undergoing PAO improved their athletic ability.

Conclusion: Patients can improve their activity level after PAO. In our cohort, more patients engaged in low-impact sports postoperatively. This can be taken into account by surgeons when counseling patients about sports activities after PAO.