Use of semi-constrained total knee arthroplasty in gonarthrosis with collateral ligament insufficiency: Clinical and functional outcomes.

INTRODUCTION: Achieving stability in total knee arthroplasty (TKA) is crucial for long-term implant survival. In cases of severe deformity or ligament laxity, constrained implants may be required. Traditionally, increasing constraint involved intramedullary stems. However, there are intermediary alternatives, including employing a constrained polyethylene insert without stems, thereby avoiding complications related to them. The study aims to evaluate our experience with a non-modular constrained (NMC) implant in primary TKA. MATERIAL AND METHODS: We conducted a retrospective review of the clinical and radiographic outcomes of 108 non-stemmed primary TKAs performed at our institution between 2013 and 2021 in patients with at least 10° deformity or 10mm ligament laxity. Data included demographics, preoperative and postoperative deformities, clinical outcomes and revision rates. RESULTS: A total of 103 patients (108 knees) with a mean age of 74 were followed up for a minimum of 2 years. The mean postoperative range of motion was 105°/0°. The median Oxford Knee Score, Knee Society Score and Knee Society Function Score were 43.5, 92 and 90, respectively. 17 knees had varus deformity (mean tibiofemoral angle of 2.7°), and 87 knees had excessive valgus deformity (mean tibiofemoral angle of 15.1°). The remaining 4 knees had a neutral alignment. The mean postoperative tibiofemoral angle was 6.8°. The overall revision rate was 6.5% (7 patients): 3 deep periprosthetic infections, 2 patellar dislocations, 1 stiffness and 1 aseptic loosening. CONCLUSION: Our experience demonstrates favorable mid-term outcomes with the NMC implant, providing a safe alternative to stemmed implants in primary TKA, particularly in cases of severe deformity or ligament laxity.

Suprapatellar tibial nailing, why have we changed? / Enclavado de tibia suprapatelar, ¿por qué hemos cambiado?

INTRODUCTION: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. MATERIAL AND METHODS: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. RESULTS: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44-91.1) vs. IP 69 (49.95-80) (p=.006), with no significant differences in other functional scales analyzed. CONCLUSIONS: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.

Enclavado de tibia suprapatelar, ¿por qué hemos cambiado? / Suprapatellar tibial nailing, why have we changed?

Introducción: El enclavado endomedular mediante abordaje infrapatelar (IP) se considera el gold estándar del tratamiento de las fracturas diafisarias de tibia, sin embargo, se ha asociado a mayor dificultad para la reducción y complicaciones como la mala alineación en procurvatum y al dolor anterior de rodilla. El abordaje suprapatelar (SP) surge como alternativa para solventar estos aspectos, asociándose también con un menor tiempo intraoperatorio y menor dosis y tiempo de fluoroscopia. Material y métodos: Estudio retrospectivo comparativo entre: un grupo de 22 fracturas intervenidas mediante abordaje SP y otro de 30 fracturas intervenidas por abordaje IP trastendinoso. Se analizaron variables perioperatorias y aspectos clínicos, radiológicos y funcionales en consulta a los 3, 6 y 12 meses. Resultados: No se encontraron diferencias entre grupos en cuanto a tiempo intraoperatorio, anemización, calidad de la reducción, o complicaciones en el seguimiento, entre otros. A los 12 meses, 12 (54,5%) casos SP y 16 (53,3%) IP presentaban dolor anterior de rodilla, sin diferencias significativas. En las escalas de evaluación, se registraron diferencias significativas en la IKDC (International Knee Documentation Committee) a favor de la técnica SP (88,45 [76,44-91,1] vs. IP 69 [49,95-80]) (p=0,006), sin diferencias significativas en otras escalas funcionales analizadas. Conclusiones: En consonancia con lo hasta ahora descrito en la literatura, el presente estudio apoya la tendencia hacia el enclavado SP por mejorar los resultados funcionales (IKDC) a medio plazo respecto a la técnica tradicional IP, sin aumentar las complicaciones. Asimismo se percibe por los cirujanos una mayor facilidad técnica para la reducción y sencillez en la obtención de imágenes radiológicas intraoperatorias.(AU)

Introduction: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. Material and methods: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. Results: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44–91.1) vs. IP 69 (49.95–80) (p=.006), with no significant differences in other functional scales analyzed. Conclusions: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.(AU)

Suprapatellar tibial nailing, why have we changed? / Enclavado de tibia suprapatelar, ¿por qué hemos cambiado?

Introduction: Endomedullary nailing using the infrapatellar approach (IP) is considered the gold standard for the treatment of tibial diaphyseal fractures, however, it has been associated with greater difficulty in reduction and complications such as malalignment in procurvatum and anterior knee pain. The suprapatellar approach (SP) arises as an alternative to solve these aspects, also being associated with a shorter intraoperative time and a lower dose and fluoroscopy time. Material and methods: Retrospective comparative study between a group of 22 fractures treated by SP approach and another of 30 fractures intervened by IP transtendinous approach. Perioperative variables were analyzed, as well as clinical, radiological, and functional aspects in outpatient visits at 3, 6 and 12 months. Results: No differences were found between groups in terms of intraoperative time, anemization, quality of reduction or complications during follow-up, among others. At 12 months, 12 (54.5%) SP cases and 16 (53.3%) IP presented anterior knee pain, without significant differences. In the evaluation scales, significant differences were recorded in the IKDC (International Knee Documentation Committee) in favor of the SP technique 88.45 (76.44–91.1) vs. IP 69 (49.95–80) (p=.006), with no significant differences in other functional scales analyzed. Conclusions: According to what has been described so far in the literature, the present study supports the tendency toward SP nailing by improving the functional results (IKDC) in the medium term compared to the traditional IP technique, without increasing complications. Likewise, surgeons perceive greater technical ease for reduction and simplicity in obtaining intraoperative radiological images.(AU)

Introducción: El enclavado endomedular mediante abordaje infrapatelar (IP) se considera el gold estándar del tratamiento de las fracturas diafisarias de tibia, sin embargo, se ha asociado a mayor dificultad para la reducción y complicaciones como la mala alineación en procurvatum y al dolor anterior de rodilla. El abordaje suprapatelar (SP) surge como alternativa para solventar estos aspectos, asociándose también con un menor tiempo intraoperatorio y menor dosis y tiempo de fluoroscopia. Material y métodos: Estudio retrospectivo comparativo entre: un grupo de 22 fracturas intervenidas mediante abordaje SP y otro de 30 fracturas intervenidas por abordaje IP trastendinoso. Se analizaron variables perioperatorias y aspectos clínicos, radiológicos y funcionales en consulta a los 3, 6 y 12 meses. Resultados: No se encontraron diferencias entre grupos en cuanto a tiempo intraoperatorio, anemización, calidad de la reducción, o complicaciones en el seguimiento, entre otros. A los 12 meses, 12 (54,5%) casos SP y 16 (53,3%) IP presentaban dolor anterior de rodilla, sin diferencias significativas. En las escalas de evaluación, se registraron diferencias significativas en la IKDC (International Knee Documentation Committee) a favor de la técnica SP (88,45 [76,44-91,1] vs. IP 69 [49,95-80]) (p=0,006), sin diferencias significativas en otras escalas funcionales analizadas. Conclusiones: En consonancia con lo hasta ahora descrito en la literatura, el presente estudio apoya la tendencia hacia el enclavado SP por mejorar los resultados funcionales (IKDC) a medio plazo respecto a la técnica tradicional IP, sin aumentar las complicaciones. Asimismo se percibe por los cirujanos una mayor facilidad técnica para la reducción y sencillez en la obtención de imágenes radiológicas intraoperatorias.(AU)

Experiencia desde el punto de vista de un traumatólogo en el Hospital COVID-IFEMA en Madrid durante la pandemia del coronavirus en España / An orthopaedic surgeon's experience at COVID-IFEMA Hospital during coronavirus pandemic in Spain

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Hematomas subcutáneos a tensión por anticoagulantes en ancianos: ¿más morbimortalidad precoz que las fracturas de cadera? / Tension subcutaneous haematomas associated with anticoagulants in the elderly: Do they have earlier morbidity and mortality than hip fractures?

Introducción: Las complicaciones del tratamiento con fármacos anticoagulantes han sido ampliamente descritas, si bien los hematomas a tensión en extremidades se consideran en muchos casos patologías banales. Material y método: Estudio descriptivo retrospectivo entre 2014 y 2017, incluyendo a pacientes con hematomas tras un mínimo traumatismo en extremidades por anticoagulantes intervenidos por Traumatología. Resultados: Se incluyó a 32 pacientes; el 81% eran mujeres, con una edad media de 83,56 años e ICCa de 5,97. La localización anatómica de los hematomas fue: el 65,6% en pierna/pie, el 15,6% en muslo/glúteo y el 18,8% en miembro superior. El 78,13% consumía acenocumarol, el 15,63% HBPM y el 3,13% NACO, siendo el 59,38% de los casos por FA, el 15,63% por valvulopatías/prótesis valvulares y el 12,5% por TEP/TVP. El tiempo medio desde el diagnóstico al drenaje quirúrgico fue de 2,66 días, principalmente por alteraciones de la coagulación. Un 46,88% fueron reintervenidos para nuevo drenaje, cura o cobertura del defecto cutáneo y 3 pacientes precisaron embolización. Fue necesaria la valoración por otras especialidades en el 78,1%. La estancia media fue de 22,34 días y la tasa de mortalidad intrahospitalaria del 9,38%. Conclusión: Los hematomas a tensión por anticoagulantes en extremidades acontecen en pacientes pluripatológicos y ancianos frágiles. Habitualmente el drenaje quirúrgico se retrasa por multitud de factores, lo que conlleva defectos cutáneos amplios que requieren reintervenciones y estancias hospitalarias prolongadas que se asocian a complicaciones médicas. En nuestro estudio, los datos de estancia media y tasa de mortalidad son superiores a los de las fracturas de cadera, por lo que no debemos subestimar esta patología

Introduction: Complications related to anticoagulant therapy have been widely described, although tension haematomas in the extremities are frequently undervalued, and commonly considered banal pathologies. Material and method: Retrospective descriptive study between 2014 and 2017, including patients with limb haematomas after minimal trauma related with anticoagulant therapy, and surgically treated by Traumatology. Results: 32 cases were eventually included, 81% were women, average age of 83.56 years, and a mean aCCI of 5.97. Anatomical location of haematomas was 65.6% in leg/foot, 15.6% in thigh/buttock, and 18.8% in the upper limb. Seventy-eight point thirteen percent received acenocoumarol, 15.63% LMWH, and 3.13% NOACs. Of the cases, 59.38% were due to AF, 15.63% to valvular heart disease/valve prosthesis, and 12.5% to PE/DVT. The mean time from diagnosis to surgical drainage was 2.66 days, mainly as a result of alterations in coagulation parameters. Forty-six point eighty-eight percent were reoperated for new drainage, cure or skin defect coverage, and 3 patients required embolisation. Of the patients, 78% needed consultation with other specialties. The average length of stay was 22.34 days, and the in-hospital mortality rate was 9.38%. Conclusion: Tension haematomas in the extremities associated with anticoagulants occur in patients with multiple comorbidities that make them vulnerable. Surgical drainage is usually delayed by numerous factors which lead to skin defects that require further surgical operations, and prolonged hospital stays that are associated with medical complications. In our study, the average length of stay and in-hospital mortality rate were higher than those for hip fractures, so we should not underestimate this pathology

Tension subcutaneous haematomas associated with anticoagulants in the elderly: Do they have earlier morbidity and mortality than hip fractures? / Hematomas subcutáneos a tensión por anticoagulantes en ancianos: ¿más morbimortalidad precoz que las fracturas de cadera?

INTRODUCTION: Complications related to anticoagulant therapy have been widely described, although tension haematomas in the extremities are frequently undervalued, and commonly considered banal pathologies. MATERIAL AND METHOD: Retrospective descriptive study between 2014 and 2017, including patients with limb haematomas after minimal trauma related with anticoagulant therapy, and surgically treated by Traumatology. RESULTS: 32 cases were eventually included, 81% were women, average age of 83.56 years, and a mean aCCI of 5.97. Anatomical location of haematomas was 65.6% in leg/foot, 15.6% in thigh/buttock, and 18.8% in the upper limb. Seventy-eight point thirteen percent received acenocoumarol, 15.63% LMWH, and 3.13% NOACs. Of the cases, 59.38% were due to AF, 15.63% to valvular heart disease/valve prosthesis, and 12.5% to PE/DVT. The mean time from diagnosis to surgical drainage was 2.66 days, mainly as a result of alterations in coagulation parameters. Forty-six point eighty-eight percent were reoperated for new drainage, cure or skin defect coverage, and 3 patients required embolisation. Of the patients, 78% needed consultation with other specialties. The average length of stay was 22.34 days, and the in-hospital mortality rate was 9.38%. CONCLUSION: Tension haematomas in the extremities associated with anticoagulants occur in patients with multiple comorbidities that make them vulnerable. Surgical drainage is usually delayed by numerous factors which lead to skin defects that require further surgical operations, and prolonged hospital stays that are associated with medical complications. In our study, the average length of stay and in-hospital mortality rate were higher than those for hip fractures, so we should not underestimate this pathology.

Actividades de vida afectadas en pacientes tras artroplastia total inversa de hombro en el contexto de artropatía de manguito rotador / Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients

Introducción y objetivos. La artroplastia total de hombro inversa en el contexto de la artropatía de manguito rotador mejora la anteversión y abducción existentes, no así las rotaciones. Nuestro objetivo es determinar la repercusión de este hecho en la realización de actividades más cotidianas. Material y métodos. Entre 2009 y 2011 se implantaron 210 artroplastias de hombro en nuestro centro. De ellas, 126 artroplastias totales de hombro inversas por artropatía de manguito rotador. El 88% eran mujeres, con una edad media en el momento de la cirugía de 81 años, encontrándose el 95% laboralmente retirados. El seguimiento medio fue de 53 meses. En cada paciente fue valorada la escala Constant, la escala visual analógica e índice de comorbilidad de Charlson, el balance articular así como la capacidad de realización de 40 actividades cotidianas, divididas según grado de demanda funcional para el hombro en un cuestionario nuevo adaptado a nuestro grupo poblacional. Resultados y discusión. El Constant medio normalizado por edad y sexo fue del 81,2%. EL valor medio de la escala visual analógica e índice de comorbilidad de Charlson medios de 3,56 y 1,69 respectivamente. Mejoría del balance articular en anteversión y abducción, no en rotaciones. Limitación para realizar actividades de baja y alta demanda funcional del 20 y 51% respectivamente, apreciándose mayor limitación en aquellas que implican rotación interna. Conclusión. La artropatía de manguito rotador en el paciente anciano tratada mediante artroplastia total de hombro inversa consigue un adecuado control analgésico y buenos resultados funcionales. Sin embargo, hay que asumir un importante riesgo de limitación en actividades cotidianas de alta demanda y que impliquen rotaciones, sobre todo interna (AU)

Introduction and objective. Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients. Material and methods. Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand. Results and discussion. Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation. Conclusion. Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand (AU)

Patient reported activities after reverse total shoulder arthroplasty in rotator cuff arthropathy patients. / Actividades de vida afectadas en pacientes tras artroplastia total inversa de hombro en el contexto de artropatía de manguito rotador.

INTRODUCTION AND OBJECTIVE: Reverse total shoulder arthroplasty in rotator cuff arthropathy patients, improves anteversion and abduction, but not rotational, outcomes. The main aim of this study is to determine its repercussions on daily life activities in our patients. MATERIAL AND METHODS: Between 2009 and 2011 we implanted 210 shoulder arthroplasties, 126 of them were reverse total shoulder arthroplasty in a rotator cuff arthropathy context. About 88% were women, with a mean age at time of surgery of 81 years, 95% were retired. The mean follow up was 53 months. The Constant scale, Visual Analogue Scale, Charlson Comorbidity Index, range of motion were measured for each patient and whether they could manage 40 daily life activities by means of a new questionnaire, classifying them according toshoulder functional demand. RESULTS AND DISCUSSION: Mean normalized by sex and age Constant value was 81.2%. Mean Visual Analogue Scale and Charlson Index were 3.56 and 1.69 respectively. Improvement in anteversion and abduction, not in rotational range of motion. Limitation was found in low and high functional demand activities in 20% and 51% respectively, especially those which involved internal rotation. CONCLUSION: Reverse total shoulder arthroplasty treatment for RCA in the elderly, achieves adequate pain management and good functional outcomes. Nevertheless, an important risk of DLA limitation must be accepted in those which involve internal rotation or shoulder high functional demand.

Evolución clínico-radiológica a largo plazo en una serie de 26 pacientes con displasia de cadera del adulto sintomática tratados mediante osteotomía periacetabular bernesa / Long-term clinical and radiological outcomes in a serie of 26 cases of symptomatic adult developmental dysplasia of the hip managed with bernese periacetabular osteotomy

Objetivo. La displasia del desarrollo de cadera es causa frecuente de dolor coxofemoral del adulto joven. La osteotomía periacetabular bernesa se perfila como una forma de abordar el problema de dolor, limitación funcional y necesidad de artroplastia a edades tempranas en estos pacientes. Material y método. Estudio descriptivo retrospectivo de 26 pacientes seleccionados con displasia del desarrollo de cadera sintomáticos, tratados mediante osteotomía periacetabular bernesa, entre 1996 y 2009 (mujeres 94%). La edad media en el momento de la cirugía era de 39,8 años (rango: 15-49), con seguimiento medio de 10 años. Valoramos radiológicamente evolución de artrosis (escala de Tönnis), índice acetabular y ángulo de Wiberg; funcionalmente utilizamos la escala de Merle-D’Aubigné-Postel. Resultados. El tiempo medio de hospitalización fue de 10 días. El valor radiográfico medio a los 10 años fue de índice acetabular: 9,03° y ángulo de Wiberg: 38,3° (corrección de 17° y 27° respectivamente, sobre valores medios preoperatorios). El 43% refería bloqueo articular y el 53% fallo del miembro no evidenciable. Valor promedio funcional de 14,30 (bueno). A los 5 años de seguimiento, el 20% progresó en al menos un grado según la escala de Tönnis respecto a su estado preoperatorio, y a los 10 años, el 55%. A largo plazo, el 83% de los pacientes no precisó artroplastia a los 10 años y el 85% de nuestros pacientes confesó alto grado de satisfacción. Conclusiones. La osteotomía periacetabular bernesa es una alternativa terapéutica útil en adultos jóvenes con displasia del desarrollo de cadera sintomática, mejorando el dolor, la cobertura cefálica femoral y retrasando la progresión de osteoartrosis coxofemoral (AU)

Objective. Developmental hip dysplasia is a frequent cause of coxofemoral pain in young adults. Bernese periacetabular osteotomy emerges as a possible option for the management of pain relief and functional limitation, in order to delay the need for arthroplasty in these patients. Material and methods. A descriptive-retrospective study was conducted on 26 selected patients with symptomatic developmental hip dysplasia treated with bernese periacetabular osteotomy between 1996 and 2009 (94% women). Mean age at time of surgery was 39.8 y (15-49y), with a mean follow-up of 10 years. Osteoarthritis (OA Tönnis scale), acetabular index and Wiberg angle were evaluated by radiology and functionality was valued by using the de Merle-D’Aubigné-Postel scale. Results. The mean hospitalization time was 10 days. At 10 years, the mean radiography value of acetabular index was 9.03° and 38.3° for Wiberg angle (17° and 27° correction, respectively, above the mean pre-operative values). Joint lock was referred to by 43% of patients, and 53% to non-evidence based limb failure. Mean functional value was 14.30 (Good). At 5 years of follow-up, 20% advanced at least by one grade in OA Tönnis scale compared to their pre-operative status, increasing to 55% at 10 years. At 10 years after surgery, 83% patients did not need arthroplasty and 85% showed high satisfaction level. Conclusions. Bernese periacetabular osteotomy is a useful alternative in young adults with symptomatic developmental hip dysplasia that can improve pain relief, femoral head coverage, and slow down coxofemoral osteoarthrosis progression in order to delay arthroplasty (AU)

[Long-term clinical and radiological outcomes in a serie of 26 cases of symptomatic adult developmental dysplasia of the hip managed with bernese periacetabular osteotomy]. / Evolución clínico-radiológica a largo plazo en una serie de 26 pacientes con displasia de cadera del adulto sintomática tratados mediante osteotomía periacetabular bernesa.

OBJECTIVE: Developmental hip dysplasia is a frequent cause of coxofemoral pain in young adults. Bernese periacetabular osteotomy emerges as a possible option for the management of pain relief and functional limitation, in order to delay the need for arthroplasty in these patients. MATERIAL AND METHODS: A descriptive-retrospective study was conducted on 26 selected patients with symptomatic developmental hip dysplasia treated with bernese periacetabular osteotomy between 1996 and 2009 (94% women). Mean age at time of surgery was 39.8 y (15-49 y), with a mean follow-up of 10 years. Osteoarthritis (OA Tönnis scale), acetabular index and Wiberg angle were evaluated by radiology and functionality was valued by using the de Merle-D'Aubigné-Postel scale. RESULTS: The mean hospitalization time was 10 days. At 10 years, the mean radiography value of acetabular index was 9.03° and 38.3° for Wiberg angle (17° and 27° correction, respectively, above the mean pre-operative values). Joint lock was referred to by 43% of patients, and 53% to non-evidence based limb failure. Mean functional value was 14.30 (Good). At 5 years of follow-up, 20% advanced at least by one grade in OA Tönnis scale compared to their pre-operative status, increasing to 55% at 10 years. At 10 years after surgery, 83% patients did not need arthroplasty and 85% showed high satisfaction level. CONCLUSIONS: Bernese periacetabular osteotomy is a useful alternative in young adults with symptomatic developmental hip dysplasia that can improve pain relief, femoral head coverage, and slow down coxofemoral osteoarthrosis progression in order to delay arthroplasty.