Impact of Periacetabular Osteotomy on Cartilage Enhancement in Crowe Group I Hip Dysplasia: A Short-Term Analysis

BACKGROUND Developmental dysplasia of the hip (DDH; congenital dislocation of the hip, or hip dysplasia) in infants and children occurs when the joint does not properly form. The group 1 Crowe classification of DDH includes <50% subluxation. This study aimed to evaluate 26 hips in 16 adolescents and young adults aged 13-35 years with Crowe group I DDH who underwent periacetabular osteotomy, with a mean follow-up of 4.5 years. MATERIAL AND METHODS Sixteen patients (26 hips; age 13-35 years) with Crowe group I DDH underwent PAO from 2015 to 2019, with a mean follow-up of 4.5 years. Evaluations included clinical indices (Harris hip score, visual analog scale [VAS] pain scores), radiographic parameters (center-edge angle, vertical-center-anterior angle, acetabular index, Sharp angle, Shenton line continuity, acetabular sourcil length), CT angles (horizontal acetabular-sector angle [HASA], anterior acetabular-sector angle [AASA], posterior acetabular-sector angle [PASA]), and MRI measurements of acetabular cartilage length and area. RESULTS Postoperative Harris hip scores significantly improved (71.65±5.42 to 87.12±4.47, P<0.05), and VAS pain scores significantly decreased (5.12±1.33 to 2.24±0.77, P<0.05). Radiographic parameters (center-edge angle, vertical-center-anterior angle, acetabular index, Shenton line continuity), CT angles (HASA, PASA, AASA), and MRI measurements of cartilage length (25.32±8.11 mm to 29.81±8.14 mm, P<0.05) and area (613.73±119.37 mm² to 710.02±117.17 mm², P<0.01) significantly improved. CONCLUSIONS Periacetabular osteotomy significantly improved short-term clinical outcomes, acetabular coverage, and cartilage morphology in the weight-bearing region in patients with Crowe group I DDH. The observed increases in acetabular sourcil length and cartilage dimensions suggest biomechanical improvements, potentially delaying osteoarthritis progression.