Bernese periacetabular osteotomy.

Seventy-five symptomatic dysplastic hip joints (63 patients) were treated with the Bernese periacetabular osteotomy during a period of 44 months. The mean patients' age was 29 years (range, 13-56 years) and the female:male ratio was 3.4:1. Group III dysplasia according to Severin was seen in 50% and Group IV dysplasia was seen in 44% of the patients. Osteoarthritis was present in 58% of the patients. Followup was obtained at a mean of 11.3 years (range, 10-13.8 years) in 71 hip joints (95%). Radiographic measurements of the lateral center edge angle, anterior center edge angle, acetabular index, lateralization of the femoral head, and intactness of Shenton's line showed a high correction potential of this type of osteotomy. In 58 patients (82%) the hip joint was preserved at last followup with a good to excellent result in 73%. Unfavorable outcome was significantly associated with higher age of the patient, moderate to severe osteoarthritis at surgery, a labral lesion, less anterior coverage correction, and a suboptimal acetabular index. Major complications were encountered in the first 18 patients including an intraarticular cut in two, excessive lateralization in one, secondary loss of correction in two and femoral head subluxation in three patients.