{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T11:30:41Z","timestamp":1789385441708,"version":"build-2803163510"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"2","license":[{"start":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T00:00:00Z","timestamp":1681257600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,26]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:p>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\u2009years (18\u201335) healed versus 35\u2009years (26\u201340) non-united, P\u2009=\u20090.001}, pre-operative lateral center-edge angle (LCEA) [16\u00b0 (11\u201320) healed versus 10\u00b0 (6\u201313) non-united, P\u2009&amp;lt;\u20090.001] and the distance from the superior ramus osteotomy to the ilioishial line [15.8\u2009mm (13.2\u201318.7) healed versus 18.1\u2009mm (16.2\u201320.5) non-united, P\u2009&amp;lt;\u20090.001] varied significantly between groups. Using multivariate analysis, moderate-to-severe dysplasia [LCEA\u2009&amp;lt;\u200915\u00b0, odds ratio (OR) 5.95, standard error (SE) 3.32, 95% confidence interval (CI) 1.99\u201317.79, P\u2009=\u20090.001], increased age (5-year increase, OR 1.29, SE 3.32, 95% CI 1.105\u20131.60, P-value\u2009=\u20090.018) and distance from the ilioishial line (3-mm increase, OR 1.67, SE 0.22, 95% CI 1.29\u20132.18, P\u2009&amp;lt;\u20090.001) were at increased risk of developing non-union. Superior ramus osteotomy non-union is common after PAO. Older age, moderate-to-severe dysplasia, and more medial osteotomy location were independent risk factors for non-union. Consideration should be made in high-risk patients for a more lateral superior ramus osteotomy and adjuvant medical and surgical interventions.<\/jats:p>","DOI":"10.1093\/jhps\/hnad006","type":"journal-article","created":{"date-parts":[[2023,4,12]],"date-time":"2023-04-12T12:23:03Z","timestamp":1681302183000},"page":"80-86","source":"Crossref","is-referenced-by-count":6,"title":["Incidence and risk factors for non-union of the superior ramus osteotomy when hip dysplasia is treated with periacetabular osteotomy"],"prefix":"10.1093","volume":"10","author":[{"given":"Ganesh","family":"Sivamurugan","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W","family":"Westermann","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalie","family":"Glass","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John C","family":"Davison","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4195-6933","authenticated-orcid":false,"given":"Aspen","family":"Miller","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Henrichsen","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd O","family":"McKinley","sequence":"additional","affiliation":[{"name":"Indiana University Health, Methodist Hospital , 1801 N Senate Boulevard, Suite 535, Indianapolis, IN 46202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6922-8471","authenticated-orcid":false,"given":"Michael C","family":"Willey","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Rehabilitation, University of Iowa Hospitals and Clinics , 200 Hawkins Drive, Iowa City, IA 52242, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,4,12]]},"reference":[{"key":"2023102711181216500_R1","doi-asserted-by":"crossref","first-page":"3","DOI":"10.2106\/JBJS.J.01734","article-title":"Radiographic structural abnormalities associated with premature, natural hip-joint failure","volume":"93","author":"Clohisy","year":"2011","journal-title":"J Bone Joint Surg Am"},{"key":"2023102711181216500_R2","doi-asserted-by":"crossref","first-page":"218","DOI":"10.2106\/JBJS.17.00337","article-title":"Intermediate-term hip survivorship and patient-reported outcomes of periacetabular osteotomy: the Washington University experience","volume":"100","author":"Wells","year":"2018","journal-title":"J Bone Joint Surg Am"},{"key":"2023102711181216500_R3","doi-asserted-by":"crossref","first-page":"247","DOI":"10.5435\/JAAOS-D-17-00810","article-title":"Ten- and 20-year survivorship of the hip after periacetabular osteotomy for 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A new radiographic incidence for the study of the hip. Its use in dysplasias and different coxopathies","volume":"28","author":"Lequesne","year":"1961","journal-title":"Rev Rhum Mal Osteoartic"},{"key":"2023102711181216500_R23","first-page":"1","article-title":"Wilcoxon rank-based tests for clustered data with R Package clusrank","volume":"96","author":"Yujing Jian","year":"2020","journal-title":"J Stat Softw"},{"key":"2023102711181216500_R24","doi-asserted-by":"crossref","first-page":"611","DOI":"10.1007\/s00264-007-0372-3","article-title":"Complications and patient satisfaction after periacetabular pelvic osteotomy","volume":"32","author":"Biedermann","year":"2008","journal-title":"Int Orthop"},{"key":"2023102711181216500_R25","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1007\/s00776-010-0010-6","article-title":"Pubic\/ischial stress fractures after eccentric rotational acetabular osteotomy","volume":"16","author":"Tsuboi","year":"2011","journal-title":"J Orthop Sci"}],"container-title":["Journal of Hip Preservation Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jhps\/article-pdf\/10\/2\/80\/52629535\/hnad006.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jhps\/article-pdf\/10\/2\/80\/52629535\/hnad006.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T11:19:00Z","timestamp":1698405540000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jhps\/article\/10\/2\/80\/7115829"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,4,12]]},"references-count":25,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023,4,12]]},"published-print":{"date-parts":[[2023,10,26]]}},"URL":"https:\/\/doi.org\/10.1093\/jhps\/hnad006","relation":{},"ISSN":["2054-8397"],"issn-type":[{"value":"2054-8397","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,7,1]]},"published":{"date-parts":[[2023,4,12]]}}}