Patients undergoing minimally invasive periacetabular osteotomy demonstrate improved outcomes: a systematic review

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.