Sports Activity After Treatment of Residual Hip Dysplasia With Triple Pelvic Osteotomy Using the Tönnis and Kalchschmidt Technique

Abstract

Background: Pelvic osteotomies are performed to prevent the progression of osteoarthritis and its associated pain due to adult hip dysplasia, particularly for young patients with no or low-grade osteoarthritis. No data are available concerning levels of sporting activity before and after triple pelvic osteotomy (TPO). Therefore, the aim of this study was to provide comprehensive data on levels of sporting activity and the subjective outcome of patients after this complex operation. Hypothesis: Patients can return to a higher level of sports activity after TPO compared with their preoperative level. Study Design: Case series; Level of evidence, 4. Methods: Between 2003 and 2011, a total of 116 triple pelvic osteotomies were performed at a single institution; the Tönnis and Kalchschmidt technique was used on 91 patients. After exclusion criteria for this study were applied, 77 patients remained (59 females and 18 males); the mean ± SD age at operation was 26 ± 3.9 years. To study outcomes, patients were asked to complete both the Harris hip score (HHS) and the Hip disability and Osteoarthritis Outcome Score (HOOS) preoperatively and at postoperative follow-up. Their level of activity was determined according to the University of California, Los Angeles (UCLA) activity score. Patients rated their hip movement and overall satisfaction preoperatively and at postoperative follow-up using a visual analog scale for sporting activity, physical fitness level, and level of pain experienced while performing their sport. Results: The mean ± SD follow-up time was 6.2 ± 1.4 years. The mean HHS changed significantly from 63.3 ± 15.6 preoperatively to 90.1 ± 10.8 at follow-up ( P < .001), and the mean HOOS changed significantly from 52.9 ± 20.1 to 82 ± 17.1 at follow-up ( P < .001). The mean UCLA activity score changed significantly from 4.8 ± 2.1 to 7.7 ± 1.4 at follow-up ( P < .001). Conclusion: Patients achieved a higher level of sports activity postoperatively. The postoperative level of participation in sports was superior, with a shift from low- to high-impact activities.