Sports Participation in Patients With Hip Dysplasia Before and Up to 20 Years After Periacetabular Osteotomy

Background: Symptomatic hip dysplasia in skeletally mature, young patients is often treated with periacetabular osteotomy (PAO). While studies have focused on radiographic and pain-related outcomes, evidence on sports participation is limited. Purpose: To determine the proportion of patients who (1) participate in sports, (2) perform their preferred sports, and (3) report improved sports performance after PAO and to investigate if preoperative patient characteristics could predict these outcomes during the first 5 years after PAO. Study Design: Cohort study; Level of evidence, 2. Methods: This cohort study investigated self-reported sports function in patients who underwent PAO using prospectively collected data from an institutional database. Eligible patients had undergone PAO and responded to at least 1 question related to sports participation. Patients reported on sports participation, ability to perform preferred sports, and improvements in sports performance before PAO as well as at 6 months and 2, 5, 10, 15, and 20 years after PAO. Results: Of 2398 patients surveyed, 1891 were eligible for inclusion. Of the respondents at each time point, 45% reported participating in sports before PAO, and 56% and 60% reported sports participation at 6 months and 2 years after PAO, respectively. Being sports active, having a higher educational level, and having a low pain level before PAO were associated with higher odds of participating in sports after PAO. An improvement in sports function was reported by 56% of the respondents at 6 months and by 61% at 2 years after PAO, and the ability to perform preferred sports was reported by 41% at 6 months and by 63% at 15 years. Time, a higher educational level, and a good quality of life score were associated with higher odds of performing preferred sports after PAO. Conclusion: Up to 62% of patients who underwent PAO for hip dysplasia participated in sports after PAO. Over half reported improved sports performance and eventually participated in their preferred sports. Being sports active or having a better pain score before PAO was predictive of participating in sports, while a high quality of life score was predictive of performing preferred sports.