Time course to clinically meaningful improvement after periacetabular osteotomy quantified

A single-institution study of 665 patients undergoing periacetabular osteotomy (PAO) for acetabular dysplasia used survival modeling to estimate the cumulative probability of reaching minimum clinically important difference (MCID), substantial clinical benefit (SCB), and patient acceptable symptom state (PASS) thresholds on the mHHS and iHOT-12 at 1, 2, 5, and 10 years. The study reported that probabilities at 1 year (ranging from 52% to 78% depending on measure and threshold) were lower than previously reported rates, but increased progressively over time, reaching 85% to 96% by 10 years; even at 10 years, 15% of patients had not achieved SCB. Prior ipsilateral hip surgery, psychiatric diagnosis, and bilateral surgery were each associated with a longer time to reach these thresholds.

Most relevant for: Patients undergoing periacetabular osteotomy for symptomatic acetabular dysplasia, particularly those with prior ipsilateral hip surgery, psychiatric comorbidities, or planned bilateral surgery.

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