Abstract
Background
Periacetabular osteotomy (PAO) is a key hip-preserving surgery for conditions such as developmental dysplasia of the hip (DDH) and other hip disorders. However, advanced cartilage loss or osteoarthritis change has traditionally been considered a contraindication. With the advent of 3D modeling and one-step autologous cartilage regeneration, this study explores the potential to extend the indications for hip preservation surgery.
Objective
The case series evaluating the outcomes of PAO combined with one-step autologous cartilage regeneration in patients with advanced cartilage damage or evidence of advanced osteoarthritis change, using 3D model-assisted planning to enhance surgical accuracy and target cartilage defects.
Methodology
This case series included five patients with DDH or Perthes disease and advanced cartilage loss who underwent PAO with one-step autologous cartilage regeneration. Preoperative 3D-printed pelvic models were used for surgical simulation and intraoperative guidance. Clinical outcomes were assessed through radiographic parameters, Harris Hip Score (HHS), and pain scores (VAS), with follow-up extending up to 2 years and minimal with 6 months.
Results
All patients demonstrated radiographic improvement in acetabular coverage and joint alignment. The five patients showed significant improvement in postoperative HHS and VAS pain scores. No major complications were reported, and the clinical improvements were sustained throughout follow-up.
Conclusions
PAO combined with one-step autologous cartilage regeneration, guided by 3D modeling, is a feasible and effective treatment for selected cases of advanced hip disease. This approach broadens surgical indications and offers young patients a promising alternative to total hip arthroplasty.