Early postoperative complications following periacetabular osteotomy: a single-center cohort study on 1,356 consecutive procedures.

Background and purpose:  Periacetabular osteotomy (PAO) is a major surgical procedure, yet data on early postoperative complications and hospitalizations remains limited. We aimed to report postoperative complications within 90 days using the modified Clavien-Dindo classification system. Our secondary aim was to report the peri- and postoperative complications observed in patients with length of hospital stay (LOS) exceeding 4 days or readmitted within 90 days following PAO.

Methods:  We identified patients who underwent PAO at a single institution between 2006 and 2021. Patient characteristics, LOS, in-hospital complications, and readmissions within 90 days postoperatively were obtained from our institutional database, patient files, and the Danish National Patient Registry to ensure complete follow up. Minor complications were defined as Clavien-Dindo grades 1 and 2, while major complications were defined as grades 3 and 4.

Results:  1,356 consecutive PAO procedures were performed in 1,096 patients with a mean age of 29.3 years (SD 11.1) and 77% females. Minor complications occurred in 499 hips (37%, 95% confidence interval [CI] 35-39) within 90 days of PAO. Only 16 (1.2%, CI 0.6-1.8) major complications were observed. LOS exceeded 4 days in 244 cases (18%) most frequently linked with nausea and emesis in 40 (2.9%). The 90-day readmission rate was 4.4% (CI 2.6-6.2), most commonly linked with pain in 11 (1.0%) and wound infection requiring antibiotics also in 11 (1.0%).

Conclusion:  PAO was associated with 37% minor complications within 90 days, while major complications were rare, occurring in only 1.2% of cases. After 18% of PAO procedures, LOS exceeded 4 days, and the 90-day readmission rate was 4.4%.