{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T02:05:44Z","timestamp":1792029944153,"version":"4.4.0"},"reference-count":42,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,1,18]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>The optimal surgical treatment (hip arthroscopy compared with periacetabular osteotomy [PAO]) for borderline acetabular dysplasia (lateral center-edge angle [LCEA], 18\u00b0 to 25\u00b0) remains a topic of debate. To date, the literature has focused primarily on arthroscopy outcomes, with only a few small reports on PAO outcomes. The purpose of this study was to define PAO outcomes in a large cohort of borderline hips. In a secondary analysis, we assessed the effect of prior failed arthroscopy, concurrent hip arthroscopy, and concurrent femoral osteoplasty on PAO outcomes in this cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A prospective database was retrospectively reviewed for patients who underwent PAO for symptomatic instability in the setting of borderline dysplasia (LCEA, 18\u00b0 to 25\u00b0). Of the 232 identified hips, 186 (80.2%) were assessed at a mean follow-up of 3.3 \u00b1 2.0 years postoperatively. The mean patient age was 25.2 \u00b1 8.5 years (range, 14 to 45 years), and 88.2% were female. Thirty hips (16.1%) had undergone a failed prior arthroscopy. Arthroscopy was performed concurrently with the PAO in 130 hips (69.9%), and femoral osteoplasty was performed concurrently in 120 hips (64.5%). The modified Harris hip score (mHHS) was assessed relative to the minimal clinically important difference (MCID) of 8 and patient acceptable symptom state (PASS) of 74. Clinical failure was defined as a reoperation for persistent symptoms or a failure to achieve either the mHHS MCID or PASS.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Of the 156 hips undergoing a primary surgical procedure, clinical success was achieved in 148 hips (94.9% [95% confidence interval (CI), 90.2% to 97.4%]). Two hips (1.3% [95% CI, 0.4% to 4.6%]) underwent reoperation (hip arthroscopy) for persistent symptoms and an additional 6 hips (3.8% [95% CI, 1.8% to 8.1%]) failed to achieve the mHHS MCID or PASS, for a clinical failure rate of 5.1% (95% CI, 2.6% to 9.8%); 8.8% reported dissatisfaction with the surgical procedure. Clinical failure was more frequent among the 30 hips (23.3% [95% CI, 11.8% to 40.9%]; p = 0.001) that had undergone a prior failed arthroscopy. There were no outcome differences between hips that had or had not undergone concurrent hip arthroscopy or femoral osteoplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>This study demonstrates excellent early outcomes of PAO for borderline acetabular dysplasia, with significant clinical improvement in 94.9% of patients undergoing a primary surgical procedure; 91.2% were satisfied with the surgical procedure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence:<\/jats:title>\n                    <jats:p>\n                      Therapeutic\n                      <jats:underline>Level IV<\/jats:underline>\n                      . See Instructions for Authors for a complete description of levels of evidence.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.22.00491","type":"journal-article","created":{"date-parts":[[2023,1,18]],"date-time":"2023-01-18T11:01:34Z","timestamp":1674039694000},"page":"137-144","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":76,"title":["Outcomes of Periacetabular Osteotomy for Borderline Acetabular Dysplasia"],"prefix":"10.2106","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7582-1415","authenticated-orcid":false,"given":"Jeffrey J.","family":"Nepple","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7462-7362","authenticated-orcid":false,"given":"Frank W.","family":"Parilla","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3549-4998","authenticated-orcid":false,"given":"Gail E.","family":"Pashos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7040-616X","authenticated-orcid":false,"given":"John C.","family":"Clohisy","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2022,11,29]]},"reference":[{"issue":"1","key":"bib1-20250430","first-page":"65","article-title":"Shelf operation in congenital dysplasia of the acetabulum and in subluxation and dislocation of the hip","volume":"35","author":"Wiberg","year":"1953","journal-title":"The Journal of Bone & Joint Surgery."},{"issue":"4","key":"bib2-20250430","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1007\/s11999-014-4055-2","article-title":"Are normal hips being labeled as pathologic? 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