The Birmingham Interlocking Pelvic Osteotomy for acetabular dysplasia: 13- to 21-year survival outcomes

Bone Joint J. 2017 Jun;99-B(6):724-731. doi: 10.1302/0301-620X.99B6.BJJ-2016-0198.R3.

Abstract

Aims: The aim of this study was to evaluate the long-term clinical and radiographic outcomes of the Birmingham Interlocking Pelvic Osteotomy (BIPO).

Patients and methods: In this prospective study, we report the mid- to long-term clinical outcomes of the first 100 consecutive patients (116 hips; 88 in women, 28 in men) undergoing BIPO, reflecting the surgeon's learning curve. Failure was defined as conversion to hip arthroplasty. The mean age at operation was 31 years (7 to 57). Three patients (three hips) were lost to follow-up.

Results: Survivorship was 76% at ten years and 57% at a mean of 17 years. Younger patients (< 20 years) had the best survivorship (20 hips at risk; 90% at 17 years; 95% confidence interval 65 to 97). Post-operative complications occurred after 12 operations (10.4%) over the duration of the study. Increasing patient age and hip arthritis grade were primary determinants of surgical failure.

Conclusion: BIPO provides good to excellent survivorship in appropriately selected patients, with a relatively low rate of complications. Our results are comparable with other established methods of periacetabular osteotomy (PAO), such as the Bernese PAO, even during the surgeon's initial learning curve. Cite this article: Bone Joint J 2017;99-B:724-31.

Keywords: Birmingham; Dysplasia; Hip; Osteotomy; Peri-acetabular; Survivorship.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Arthroplasty, Replacement, Hip
  • Bone Diseases, Developmental / diagnostic imaging
  • Bone Diseases, Developmental / surgery*
  • Child
  • Female
  • Humans
  • Ilium / surgery
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Osteotomy / adverse effects
  • Osteotomy / methods*
  • Pelvic Bones / diagnostic imaging
  • Pelvic Bones / surgery*
  • Prospective Studies
  • Radiography
  • Retrospective Studies
  • Treatment Outcome
  • Young Adult