High complication rates seen in obese adolescents after Bernese PAO
Despite radiographic correction of acetabular dysplasia in obese adolescents after Bernese periacetabular osteotomy, complication rates were high, according to these study results.
Researchers retrospectively identified 84 patients (mean age 16.5 years) with acetabular dysplasia from three institutions who underwent Bernese periacetabular osteotomy (PAO) and were followed up for 37 months, mean. They recorded the patients’ demographics, BMI, treatment outcomes and radiographic outcomes. The 2000 Center of Disease growth charts were used to define obesity as BMI ≥ 95 percentile. Complications were graded with the modified Clavien-Dindo complication scheme and divided by levels of severity.
Radiographs were used to evaluate the lateral center-edge angle (LCEA), anterior center-edge angle (ACEA) and Tönnis angle. Correlations between obesity and complication development were tested with multivariable logistic regression analysis and linear mixed–model regressions were used to analyze correlations between obesity and surgical-related changes.
Findings showed nine patients required a change in postoperative treatment due to complications and seven patients with complications did not require a change. Among the cohort, 11% of patients were considered obese.
Results from the univariate logistic regression analysis showed only obesity was significantly correlated with complication development. Preoperative Tönnis angle, age, sex and time from initiation of study to date of the patient’s surgery were not significantly correlated with complication development. The odds of complication development in obese patients were 10 times those of nonobese patients. However, the investigators observed no difference between obese and nonobese study participants for change in angular correction for ACEC, LCEA and Tönnis angle. ‒ by Monica Jaramillo
Disclosures: Novais reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.