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The functional outcomes of periacetabular osteotomy (PAO) and factors predicting outcome in the older patient with acetabular dysplasia are not well understood. We therefore retrospectively determined the functional outcome of 70 patients (87 hips) over age 40 treated with PAO in three institutions; we also determined whether preoperative factors, particularly the presence of osteoarthritis, influenced the survival of the hip or time to total hip arthroplasty after PAO. The average age at surgery was 43.6 years. The minimum followup was 2 years (mean, 4.9 years; range, 2-13 years). Twenty-one hips (24%) had undergone total hip arthroplasty (THA), at a mean of 5.2 years after PAO (range, 1.9-7.6 years). Surviving hips had a mean improvement in Harris hip score from 60.7 to 90.3 and in total WOMAC pain score from 8.7 to 3. We observed no differences in preoperative or postoperative radiographic measurements or preoperative clinical function scores (HHS, WOMAC) in hips surviving and hips having THA. The risk of THA at 5 years after PAO was 12% in hips with preoperative Tönnis Grade 0 or 1 and 27% for Tönnis Grade 2. Our preliminary study suggests that PAO will give satisfactory functional and pain scores in patients over age 40 having dysplastic hips with mild or no arthrosis. [ABSTRACT FROM AUTHOR]

Background: Loosening of a cemented glenoid component is an important cause of failure in shoulder arthroplasty. This study was developed to examine the outcome of patients managed with a metal-backed, bone-ingrowth glenoid component as an alternative to a cemented component.Methods: The study group included eighty-three total shoulder arthroplasties with a metal-backed, bone-ingrowth glenoid component performed between 1989 and 1994. Seventy-four shoulders had a diagnosis of primary osteoarthritis, and nine shoulders had other diagnoses. All patients were followed radiographically and clinically for a minimum of two years or until the time of revision surgery. Kaplan-Meier survival estimates were performed with revision and/or radiographic failure as the end points.Results: The mean clinical follow-up was 9.5 years, and the mean radiographic follow-up was 7.1 years. Pain ratings (on a scale of 1 to 5) decreased from a mean of 4.7 preoperatively to 2.0 postoperatively. The mean range of motion in active elevation increased from 102 degrees preoperatively to 135 degrees postoperatively; the mean external rotation increased from 27 degrees to 56 degrees . Glenohumeral joint instability developed in fourteen shoulders. Radiographic changes consistent with glenoid component loosening were present in thirty-three shoulders. Polyethylene wear with metal wear of the glenoid component was noted in twenty-one shoulders, and humeral component loosening was seen in fifteen shoulders. Revision procedures were performed in twenty-six shoulders. There were no identifiable patient, disease, or surgical characteristics associated with failure, either clinically or radiographically. The five-year survival estimate free of revision or radiographic failure was 79.9% (95% confidence interval, 71.6% to 89.3%), and the ten-year survival estimate was 51.9% (95% confidence interval, 41.0% to 65.8%).Conclusions: The high rate of failure of total shoulder arthroplasties performed with this metal-backed, bone-ingrowth glenoid component raises concerns as to its use, and perhaps the use of other types of metal-backed components, in shoulder arthroplasty, other than for special situations.Level Of Evidence: Therapeutic Level IV. See Instructions to Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]