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Objectives and questions: Developmental dysplasia of the hip (DDH) is among the most common congenital musculoskeletal disorders and may lead to early coxarthrosis if left untreated. Modified Pemberton acetabuloplasty is an established, growth-preserving osteotomy technique for surgical correction in childhood. However, robust long-term clinical outcomes beyond two decades of follow-up remain scarce. The aim of this study was to retrospectively evaluate functional and patient-reported outcomes after an average follow-up of 25.6 years.

Material and methods: In this monocentric retrospective cohort study, 63 patients (92 hips) were included from an original cohort of 331 patients with 507 operated hips who had undergone modified Pemberton acetabuloplasty between 1990 and 1995. In 2018, clinical follow-up was performed in 54 patients. Standardized PROMs included Harris Hip Score (HHS), WOMAC, and EQ-5D. Data were analyzed descriptively. Level of evidence C.

Results: The mean follow-up period was 25.6 years. The average HHS was 95.8 points, the mean WOMAC index 7.2 points, and the EQ-5D-VAS 89.3/100. A total of 81% of patients were free of symptoms, and 83.3% achieved excellent functional results. Overall, 96.8% rated the surgical outcome as good or very good and 92% would choose to undergo surgery again. No patient required conversion to total hip arthroplasty and no major complications occurred.

Discussion and conclusions: Modified Pemberton acetabuloplasty demonstrates stable functional outcomes, low symptom levels, and high health-related quality of life more than 25 years after surgery. The high patient satisfaction and the absence of secondary procedures underscore the long-term clinical effectiveness of this growth-preserving treatment option for DDH.