Incidence and risk factors for non-union of the superior ramus osteotomy when hip dysplasia is treated with periacetabular osteotomy

• Published in: Journal of hip preservation surgery 2023-07, Vol.10 (2), p.80-86
• Main Authors: Sivamurugan, Ganesh, Westermann, Robert W, Glass, Natalie, Davison, John C, Miller, Aspen, Henrichsen, Jacob, McKinley, Todd O, Willey, Michael C
• Format: Article
• Language: English
• ISSN: 2054-8397; 2054-8397
• DOI: 10.1093/jhps/hnad006

ABSTRACT Periacetabular osteotomy (PAO) is a well-established surgical treatment for hip dysplasia. Few studies report risk factors for the development of superior ramus osteotomy non-union. The purpose of this investigation was to document the incidence and risk factors for this complication. We identified 316 consecutive hips that underwent PAO for symptomatic acetabular dysplasia with a minimum 1-year radiographic follow-up. We developed and validated a technique to measure the superior ramus osteotomy location on anterior-posterior (AP) pelvis radiographs and computed tomography. Logistic regression with generalized estimating equations was used to evaluate the relationships between odds of non-union and potential demographic and radiographic predictor variables in univariate and multivariate analyses. Twenty-nine (9.2%) hips developed superior ramus non-union. Age {median [interquartile range (IQR)] 23 years (18–35) healed versus 35 years (26–40) non-united, P = 0.001}, pre-operative lateral center-edge angle (LCEA) [16° (11–20) healed versus 10° (6–13) non-united, P