ePoster #1106 - ISHA Annual Scientific Meeting 2016

The Birmingham Interlocking Pelvic Osteotomy (BIPO) for Acetabular Dysplasia: 13 to 21 Year Survival Outcomes

Omer Mei-Dan, MD, Aurora, CO UNITED STATES
Dylan Jewell, BSc, MSc, FRCS, Haverfordwest, Pembrokeshire UNITED KINGDOM
Tigran Garabekyan, MD, North Hollywood, CA UNITED STATES
Jason Brockwell, FRCSEdOrth, Hong Kong HONG KONG
David Alexander Young, MBBS FRACS (Orth), Melbourne, Victoria AUSTRALIA
Callum McBryde
Matthew J. Kraeutler, MD, Boulder, CO UNITED STATES
John O'hara, FRCS, FRCSI, FRCSC, MCH, Birmingham UNITED KINGDOM

Birmingham Hip Clinic, Birmingham, UNITED KINGDOM

FDA Status Not Applicable

Summary: The Birmingham Interlocking Pelvic Osteotomy provides good to excellent survivorship in appropriately selected patients with symptomatic acetabular dysplasia.

Abstract:
In patients with symptomatic acetabular dysplasia, the goals of pelvic osteotomy are to provide the patient with a pain-free hip joint and to enable pre-injury levels of activity. The Birmingham Interlocking Pelvic Osteotomy (BIPO) represents a novel form of periacetabular osteotomy (PAO) that addresses several shortcomings of previously described methods. The purpose of this study was to evaluate the long-term clinical and radiographic outcomes of the Birmingham Interlocking Pelvic Osteotomy. In this prospective study, we report the mid- to long-term clinical outcomes of the first 100 consecutive patients undergoing BIPO, reflecting the surgeon’s learning curve. Failure was defined as conversion to hip arthroplasty. The mean age at operation was 31 years (range, 7 to 57 years) with a 2.5% attrition rate at a mean follow-up of 17.5 years (range, 13.8 to 21.5 years). Survivorship was 76% at a mean of 12.5 years and 54% at a mean of 17.5 years. Younger patients (under the age of 20) had the best survivorship (89% at 17.5 years). There was no significant difference in the postoperative lateral center edge (LCE) angle in surviving versus failed BIPOs (49.8 degrees versus 51.3 degrees, p = 0.72). Postoperative complications occurred in 10.4% of all cases over the duration of the study. Increasing patient age and hip arthritis grade were primary determinants of surgical failure. The following were not found to be associated with surgery failure: pre-operative sourcil angle (p = 0.23), pre-operative LCE angle (p = 0.54), and postoperative sourcil angle (p = 0.93). BIPO provides good to excellent survivorship in appropriately selected patients, with a relatively low rate of complications. Our results are comparable to other established methods of PAO, such as the Bernese PAO, even during the surgeon’s initial learning curve.