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    2. Deutscher Kongress für Orthopädie und Unfallchirurgie 2026 (DKOU 2026)
    3. Revision periacetabular osteotomy enhances joint function and activity level after failure of redirectional pelvic osteotomies at skeletal maturity
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Deutscher Kongress für Orthopädie und Unfallchirurgie 2026 (DKOU 2026)

Deutsche Gesellschaft für Orthopädie und Unfallchirurgie (DGOU), Deutsche Gesellschaft für Orthopädie und Orthopädische Chirurgie (DGOOC), Deutsche Gesellschaft für Unfallchirurgie (DGU), Berufsverband für Orthopädie und Unfallchirurgie (BVOU)
20.-23.10.2026
Berlin

Meeting Abstract

Revision periacetabular osteotomy enhances joint function and activity level after failure of redirectional pelvic osteotomies at skeletal maturity

Maximilian Fischer - Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Deutschland
Andreas Nitsch - Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Deutschland
Feras Kasabji - Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Deutschland
Jens Goronzy - Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Deutschland
Georgi Wassilew - Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Deutschland

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Objectives and questions: There is a paucity in literature regarding functional outcomes of revision periacetabular osteotomy (R-PAO) after failure of previous redirectional pelvic osteotomy at mature skeleton. This study aimed to compare the surgical and patient-reported outcomes (PROMs) between R-PAO and primary PAO.

Material and methods: Patients undergoing R-PAO (n = 13) and primary PAO (n = 39) were matched in a 1:3 ratio for age, sex and surgical date with a minimum follow-up of one years. PROM assessment included scores for pain, joint functionality (mHHS – modified Harris-Hip; iHot12 - international Hip outcome tool-12) and activity level (UCLA – University of California Los Angeles activity scale). Postoperative outcomes were compared between the groups using independent samples t-tests and Mann–Whitney U test. Multivariable linear regression were used to identify predictors of postoperative outcome improvement.

Results: A total of 52 patients were included with a mean follow-up of 3.1 years. Patients undergoing R-PAO had significant worse preoperative joint function (mHHS 34.91 - 57.28, p< 0.001; iHot-12 33.17 - 46.22, p=0.005) and activity level (UCLA 4.38 - 6.34, p=0.004) compared to primary PAO. While achieving similar functional improvement (Dpre – post, p>0.05) comparing both groups, mHHS (70.21 – 86.81, p= 0.002) and pain score (3.46 – 1.92, p=0.010) remained significant worse after R-PAO. Multivariable linear regression analysis revealed, that preserved preoperative joint function (iHot-12 β=0.795, p<0.001; mHHS β=0.696, p<0.001) and activity level (UCLA β=0.360, p<0.001), a lower BMI (iHot-12 β= -2.011, p=0.002; UCLA β= -0.120, p=0.041) and a sufficient postoperative anterior wall coverage (iHot-12 β=0.849, p<0.001) are predictors of improved postoperative outcomes in both R-PAO and primary PAO.

Discussion and conclusions: Failure of hip preserving pelvic osteotomies in skeletal mature patients result in a substantial symptom burden and functional impairment. R-PAO represents a considerable treatment strategy that preserves the native hip joint and can lead to improved postoperative outcomes. However, postoperative outcomes after R-PAO remains inferior to those of primary PAO, due to the worse preoperative joint function.