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German Congress of Orthopaedics and Traumatology (DKOU 2023)

24. - 27.10.2023, Berlin

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Periacetabular osteotomy with a modified fixation technique using K-wires shows comparable results to classic screw fixation at mid-term follow-up

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  • presenting/speaker Vincent Justus Leopold - Charité – Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Klinik für Unfall- und Wiederherstellungschirurgie, Berlin, Germany
  • Christian Hipfl - Charité – Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Klinik für Orthopädie, Berlin, Germany
  • Robert Karl Zahn - Charité – Universitätsmedizin Berlin, Klinik für Orthopädie, Centrum für Musculoskeletale Chirurgie, Berlin, Germany
  • Matthias Pumberger - Charité – Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Klinik für Unfall- und Wiederherstellungschirurgie, Berlin, Germany
  • Carsten Perka - Charité – Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Berlin, Germany
  • Sebastian Hardt - Charité – Universitätsmedizin Berlin, Centrum für Muskuloskeletale Chirurgie (CMSC), Klinik für Unfall- und Wiederherstellungschirurgie, Berlin, Germany

Deutscher Kongress für Orthopädie und Unfallchirurgie (DKOU 2023). Berlin, 24.-27.10.2023. Düsseldorf: German Medical Science GMS Publishing House; 2023. DocAB31-2060

doi: 10.3205/23dkou123, urn:nbn:de:0183-23dkou1231

Published: October 23, 2023

© 2023 Leopold et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

Text

Objectives: The optimal fixation technique in periacetabular osteotomy (PAO) remains controversial.Modified fixation with K-wires was described as a feasible, reproducible and safe alternative. However, clinical follow-up of patients treated with this technique is lacking to date.

Hypothesis: Patients treated with PAO with modified fixation technique with K-wires achieve equivalent improvements in functional outcome and joint preservation as patients treated with the original technique with screw fixation.

Methods: We performed a retrospective analysis of prospectively collected data of 202 consecutive PAO cases at a single university center between 01/2015 and 06/2017. A total of 123 cases with complete datasets were included in the final analysis. Patients who underwent PAO with a fixation technique with K-wires (n=63) were compared with screw fixation (57). Medium follow-up was 63±10 months. Functional outcome was assessed using the International hip outcome tool (iHOT 12), Subjective Hip value (SHV), UCLA activity score (UCLA). Pain and patient satisfaction on the Numerical Rating Scale (NRS) were evaluated. Joint preservation was defined as non-conversion to total hip arthroplasty (THA).

Results and conclusion: Preoperative baseline joint function in both fixation groups was similar. In both groups function as measured by above-mentioned PROMs (p=<0.001) and pain on NRS (p=<0.001) improved significantly. Postoperative functional outcome was similar in both groups with no significant difference for postoperative PROMs: iHOT 12 (71.8±25.1 vs. 73±21.1; p=0.789), SHV (77.9±21.2 vs. 82.4±13.1; p=0.192), UCLA activity score (6.9±1.6 vs. 6.9±1.9; p=0.909), pain on NRS (2.4 ±2.1 vs. 2.0 ±2.1; p=0.302). Patient satisfaction did not differ significantly (7.6±2.6 vs. 8.2±2.2; p=0.170). Joint preservation was equally successful with low conversion rates to THA in both groups (2 vs. none; p=0.497).

Periacetabular osteotomy with a modified fixation technique with K-wires provided excellent clinical results at mid-team follow-up, comparable to those of screw fixation. The technique can therefore be considered a viable option when deciding on the fixation technique in PAO.