Exploring the Experiences and Expectations of Adolescent Females Undergoing Periacetabular Osteotomy

Abstract

Background: Adolescents presenting with symptomatic acetabular dysplasia (AD) complain of pain and reduced participation in activities of daily living (ADLs). Periacetabular osteotomy (PAO) is widely accepted as the preferred treatment for AD. Understanding the patient experience can lead to improvements in psychosocial and physical burden in adolescents. We sought to explore the experiences and expectations of adolescent females with AD who underwent a PAO. Methods: We conducted semistructured interviews with adolescent females who underwent a PAO >6 months ago. Questions focused on exploring their experiences with AD and their PAO expectations and decision-making. Participants also completed a 7-item Likert-scale questionnaire related to factors they considered in their decision-making, which was followed by a ranking of those considerations. We utilized an inductive and deductive coding approach to identify key themes from interviews and descriptively analyzed questionnaire responses. Results: Eighteen adolescent females between 13 and 19 years (17.2±1.9 y) at the time of PAO participated in the study. Time from surgery to interview ranged from 203 to 1534 days (927.7±320.8 d). Key themes included (1) prolonged time from symptom onset to PAO, with many seeing several providers; (2) major preoperative apprehensions of surgical outcome and setbacks in school and recreational activities; (3) discussion with the physician and people who underwent PAO were the most beneficial sources of information; (4) Postoperative worries include surgical outcome and return to daily living. Eighty-nine percent of participants reported that return to daily activities and sustaining long-term hip health were very important factors in their PAO decision-making, and 61% ranked their return to daily activities as their top priority. Conclusions: Adolescent females with AD report frustrating delays in diagnosis and appropriate intervention and value their return to daily living in their decision to undergo PAO. The development of future patient-centered interventions may improve the PAO decision-making process and should include information related to surgical recovery and anecdotes of others who underwent this procedure. Level of Evidence: Level IV, therapeutic study.