EP2.14 PROMs, MCID, SCB, and PASS in Triple Osteotomy - Significant Improvement in Quality of Life in Patients with Hip Dysplasia

Abstract

Objective: Triple osteotomy allows for improved coverage of the femoral head in patients with hip dysplasia. While previous research has focused on survival analyses of the procedure, functional analyses following triple osteotomy are insufficiently explored. The aim of this study is to analyze mid-term clinical outcomes after triple osteotomy using the International Hip Outcome Tool 33 (iHOT33) and to identify potential demographic predictors.

Methods: This study is a non-randomized, non-controlled retrospective registry study conducted within the German Cartilage Registry. All patients (n=48) were operated on by the same hip specialist due to radiologically confirmed hip dysplasia (preoperative vertical center-edge angle [VCE] 16° ± 5°, acetabular index 10° ± 5°) using triple osteotomy. The postoperative treatment protocol was standardized. The follow-up rate at 24 months was 60.4% with a mean follow-up time of 24 months. In addition to iHOT33, subjective quality of life, pain assessed by visual analog scale (VAS), satisfaction with the operation, perceived individual treatment benefit, and unemployment rate were recorded. All relevant hip angles were determined pre- and postoperatively using standard radiographs. Paired t-tests and regression analyses were used for statistical analysis. A significance level of p < 0.05 was considered statistically significant.

Results and Conclusion: The preoperative iHOT-33 total score was 46.9 points, which significantly increased to 70.8 after 24 months (delta 23.9 points), with all subdomains of the score showing significant increases. The most significant improvements occurred in the first 6 months postoperatively, with a delta of 15.8 points, with the “social” subdomain showing the greatest numerical differences (delta 30 points). Postoperatively, the radiologically defined angles (VCE 31° ± 4°, acetabular index 0° ± 3°) were within the normal range. Regression analysis showed no significant correlation between the change in iHOT33 scores and any of the variables examined. After 24 months, 79% of patients felt well (PASS), 50% reached the minimal clinically important difference after 12 months, and 67% after 24 months, with 69% experiencing a substantial clinical benefit with desirable functional status after 2 years.

This study demonstrates that triple osteotomy significantly improves the subjective quality of life of patients with hip dysplasia, particularly benefiting participation in social life.