The Journal of Hip Preservation Surgery (JHPS) is not the only place where work in the field of hip preservation can be published. Although our aim is to offer the best of the best, we are continually fascinated by work, which finds its way into journals other than our own. There is much to learn from it, and so JHPS has selected six recent and topical subjects for those who seek a summary of what is taking place in our ever-fascinating world of hip preservation. What you see here are the mildly edited abstracts of the original articles, to give them what JHPS hopes is a more readable feel. If you are pushed for time, what follows should take you no more than 10 min to read. So here goes…
Periacetabular osteotomy (PAO) has demonstrated favourable outcomes for the treatment of acetabular dysplasia. Minimally invasive (MI) PAO uses a smaller incision to preserve soft tissue, minimize complications, and accelerate recovery; however, the outcomes of MI PAO are still being established. The purpose of this study was to conduct a systematic review to assess the reoperation rates and patient-reported outcomes following MI PAO. A systematic review of the literature was conducted in PubMed, CENTRAL, and Scopus in April 2024 with the following keywords: (mini*) AND (periacetabular osteotomy"). The PRISMA criteria were used. Only studies that reported on patient-reported outcome measures (PROMs) of MI PAO techniques were included. Eight studies with study periods ranging between 2004 and 2021 including a total of 2247 hips were included in this review. Mean follow-up ranged from 12 to 60 months. The mean age at the time of surgery ranged from 20.0 to 38.7 years, and 85.6% of included hips were from female patients. Seven out of 8 included studies reported significant improvement in preoperative vs postoperative PROMs. The mean Non-Arthritic Hip Score ranged from 49.8 to 58.7 preoperatively compared to 77.2-89.4 postoperatively. Mean UCLA scores ranged from 3.9 to 4.67 preoperatively to 6.3-6.97 postoperatively. Mean Harris Hip Scores ranged from 50.8 to 66 preoperatively compared to 87.4-93 postoperatively. Conversion to THA rates ranged from 0% to 5.3% at a mean of 4.9 years (0.6-14). Patients undergoing MI PAO surgery for the treatment of acetabular dysplasia demonstrated low rates of conversion to THA and significant improvement in PROMs at short- to mid-term follow-up.
To perform a systematic review that identifies the percentage of arthroscopic hip surgery publications that obtain postoperative plain radiographs (and type, and when) and the accuracy of the osseous corrections performed. A systematic review was conducted utilizing PRISMA guidelines. Arthroscopic hip preservation surgery publications were included over a 20-year publication eligibility period. Synthetic reviews were excluded. Studies reporting accuracy of correction based on intra-operative fluoroscopic and/or dynamic arthroscopic examination alone, but without postoperative plain radiographs, were excluded. Publications were screened for the presence, type, and timing of postoperative radiographs and measurements performed quantifying femoral head-neck junction sphericity. Descriptive statistics and logistic and multivariate regression analyses were performed. Two-hundred fifty-six publications (29 381 hips; 14 692 female; mean age range 14.8-65.8 years). The most common surgical indication was labral tear (13 112 hips [44.7% of hips]). There was an inverse correlation between publication year and obtaining postoperative radiographs (r = -0.128, P < .05). Only 69 publications (27%) reported obtaining postoperative radiographs. Among those, 40 publications (16%) specified the type of radiographs. Only 22 publications (9%; 1538 hips [5% of hips]) reported that patients had an accurate osseous correction. This systematic review has shown that only 9% of arthroscopic hip preservation surgery publications (5% of hips) reported an accurate osseous correction on postoperative radiographs. Given this finding, writers, reviewers, editors, and publishers of hip preservation surgery literature should necessitate the transparent reporting of the accuracy of osseous corrections performed on standardized radiographs. Level IV, systematic review and/or meta-analysis of studies with Levels I to IV.
