Jin Yamaguchi

Pelvic osteotomy for middle-aged patients with hip dysplasia remains controversial. We asked whether pelvic osteotomy would yield lower Harris hip scores and survivorship in older patients than in younger patients. We compared patients younger than 50 years (n = 123) with patients 50 years or older (n = 41). At last followup, the mean Harris hip scores improved similarly in both groups: from 60 to 89 points in the older group and from 63 to 92 points in the younger group. However, in patients with bilateral surgery, the older group tended to have lower mean scores than the younger group (86 versus 93 points, respectively). Fifteen-year survivorship with a Harris hip score less than 80 points as the end point was similar in the two groups (71% in older patients and 81% in younger patients). In patients with bilateral surgery, the 15-year survivorship was lower in the older group (66% in older patients and 83% in younger patients). The data suggest eccentric rotational osteotomy for older patients can provide lasting function in most patients. However, prudent selection of patients is required for older patients with bilateral osteoarthritis. Level of Evidence: Level IV, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.

Osteoporosis is a multifactorial genetic disease which greatly increases the risk of bone fracture in elderly persons.