Total Hip Arthroplasty After Pelvic Osteotomy for Acetabular Dysplasia: A Systematic Review
Authors: Shapira J, Annin S, Rosinsky PJ, Maldonado DR, Lall AC, Domb BG
DOI: 10.1016/j.jor.2021.04.001
Background
Pelvic osteotomy (PO) corrects acetabular dysplasia but may complicate subsequent total hip arthroplasty (THA).
Methods
Systematic review comparing outcomes and complications of THA performed after PO versus primary THA without prior osteotomy.
Key Findings
- THA following PO is associated with increased intraoperative blood loss, difficulty with cup positioning, and inferior patient-reported outcomes.
- Hip dislocation was the most common complication after THA post-PO.
Conclusions
THA after pelvic osteotomy can be successful but carries higher risks and technical challenges compared to standard primary THA.
What Does This Mean for Providers?
- Surgeons should anticipate greater technical complexity during THA in patients with prior PO, including challenges in implant positioning.
- Risk counseling should include the potential for increased blood loss and dislocation.
- Surgical planning may require advanced imaging and specialized techniques to optimize outcomes.
- Consider multidisciplinary planning for complex cases with prior hip preservation surgery history.