Background Recent literature has found failed hip arthroscopy to be associated with worse short-term outcomes after periacetabular osteotomy (PAO). This study aimed to assess its relationship with mid-term PAO outcomes. Methods Patients with acetabular dysplasia undergoing isolated PAO with or without concomitant hip arthroscopy between 2016 and 2020 were identified. Patients with minimum 2-year follow-up from their most recent PAO with PROMs were included (161 patients, 216 hips). Patients were placed into the PREVSCOPE group, consisting of those who had undergone hip arthroscopy before PAO (47 patients, 52 hips), or the PAOALONE group, consisting of patients who had not (114 patients, 164 hips). The modified Harris Hip Score (mHHS) and International Hip Outcome Tool-12 (iHOT-12) were assessed. The MCID was defined as an outcome change ≥ 18 for mHHS and ≥ 26 for iHOT-12. PASS was defined as a postoperative score of ≥ 71 for mHHS and ≥ 65 for iHOT-12. Radiographic parameters were analyzed by hip, while PROMs were analyzed by patient. Results The mean preoperative lateral center edge angle was higher (p < 0.001), and the mean alpha angle was lower (p < 0.001) in the PREVSCOPE group. There was no difference in Tönnis grade, femoral version, or acetabular version between groups. Mean follow-up was 6 ± 2 years for both groups. There was no difference in mean preoperative mHHS or iHOT-12 scores. When controlling for prior failed arthroscopy, anatomical factors, age, BMI, preoperative PROMs, and procedure number, no differences were found in PASS or MCID rates for mHHS or iHOT-12 between groups. Conclusion This study found failed hip arthroscopy was not associated with worse PAO outcomes at mid-term follow-up. Surgeons can be confident offering PAO to appropriately selected patients regardless of prior arthroscopy; however, these patients should be made aware of the potentially slower recovery.
Jochl et al. (Thu,) studied this question.