Abstract
Background:
Studies have shown that athletes can return to sport (RTS) after periacetabular osteotomy (PAO). However, the rate and postoperative level of athletic competition is highly variable. There are few studies evaluating RTS after PAO in the pediatric population (1-5) This study aims to report competitive RTS rates of pediatric patients who underwent periacetabular osteotomy with concomitant hip arthroscopy (HA+PAO) by a single surgeon.
Hypothesis:
We hypothesize that there will be a high RTS rate (>80%) after periacetabular osteotomy with concomitant hip arthroscopy.
Methods:
Patients who underwent a HA+PAO by a single surgeon between January 2015 and September 2023 were retrospectively reviewed. All patients who were at least 18 years old at the time of surgery, underwent isolated PAO, or were involved in only unorganized/recreational sports were excluded. Patients who reported sports participation at the middle school, high school or competitive club (regional, national, or international competitions) level before surgery and desired to return to their sport postoperatively were included. Patient demographics, radiographic measurements, and level of play preoperatively and postoperatively were obtained through chart review or direct contact.
Results:
Twenty-five patients (22 female) met inclusion criteria. The average age and BMI at the time of surgery were 15.98 ± 1.02 years and 22.97 ± 3.42, respectively. Preoperatively, one participated in middle school sports, 13 in high school sports, and 11 in competitive level club sports. Lateral center edge angle increased from 16.84 ± 4.25 preoperatively to 32.8 ± 2.86 degrees postoperatively, and acetabular index decreased from 12.92 ± 4.30 to 0.92 ± 3.07 degrees. Postoperatively, 22 returned to sport, 2 did not RTS, and one was lost to follow-up, for an over RTS rate of 92%, excluding those lost to follow-up. Of the 22 who returned, 15 returned to the same preoperative level of sport, 5 returned to a higher level, and 2 returned to a lower level.
Conclusion:
Of the patients with follow up, there was an overall 92% rate of return to competitive sports after scope/PAO in pediatric patients, with 91% of those patients returning to the same or higher level of sport. These results affirm that young athletes can successfully return to sport after combined hip arthroscopy and PAO for hip dysplasia and counseling of these athletes should reflect these promising expectations.