Does travel distance influence short-term outcome after periacetabular osteotomy?-A cohort study.

PURPOSE: Periacetabular osteotomy (PAO) is an established joint-preserving procedure for the treatment of developmental dysplasia of the hip (DDH). As PAO is typically concentrated in specialized centres, many patients travel considerable distances for treatment. The purpose of this study was to evaluate the influence of travel distance on short-term outcomes following PAO.

METHODS

This prospective registry study included 296 hips undergoing PAO for DDH between January 2022 and May 2025 by a single experienced surgeon. Travel distance was determined using driving distance, and hips were stratified into two groups: ≤80.5 and >80.5 km from the treating centre. Radiographic parameters, patient-reported outcome measures (PROMs) and rates of achieving the Patient Acceptable Symptom State (PASS) and Minimal Clinically Important Difference (MCID) for the modified Harris Hip Score (mHHS) and international Hip Outcome Tool-12 (iHOT-12) were analysed.

RESULTS

A total of 126 hips (43%) resided ≤80.5 km and 170 hips (57%) >80.5 km from the treating centre. Hips of patients travelling longer distances demonstrated a lower preoperative lateral centre-edge angle (p = 0.005) and a higher extrusion index (p = 0.034). No significant differences were observed in demographics, comorbidities, concomitant procedures or preoperative PROMs. All PROMs improved significantly in both groups (all p < 0.05). Postoperative PROMs, magnitude of improvement, PASS and MCID achievement rates and complication rates did not differ significantly between groups. Travel distance was not an independent predictor of postoperative outcomes in multivariable regression analyses.

CONCLUSION

Travel distance to a specialized hip preservation centre does not influence short-term outcomes following PAO. Comparable functional outcomes and complication rates can be achieved irrespective of travel distance, supporting the feasibility of centralized PAO care in specialized high-volume centres.

LEVEL OF EVIDENCE: Level III.