# Triple‐Osteotomy leads to substantially improved quality of life in patients with hip dysplasia

## TL;DR

Triple-osteotomy surgery significantly improves quality of life and reduces pain in patients with hip dysplasia, especially in social and sports-related aspects.

## Contribution

This study provides mid-term evidence of the clinical benefits of triple-osteotomy for hip dysplasia using patient-reported outcomes.

## Key findings

- iHOT33 scores improved from 46.9 preoperatively to 70.8 at 24 months.
- The 'social' subdomain showed the greatest improvement of 30 points.
- Postoperative angles were within normal ranges, with no significant correlation between angle changes and outcome scores.

## Abstract

Triple‐Osteotomy (TO) is a hip‐preserving surgical technique designed to correct symptomatic hip dysplasia by achieving three‐dimensional acetabular reorientation and improving femoral head coverage. This procedure has shown promising outcomes in pain reduction, functional recovery, and quality of life, particularly in young, active patients. While periacetabular‐osteotomy (PAO) is another well‐established method for hip preservation, the specific advantages of TO, especially in early recovery and patient‐reported outcomes (PROMs), remain underexplored. This study evaluates the mid‐term outcomes of TO using the iHOT33 tool to provide a comprehensive understanding of its clinical benefits.

This non‐randomised, retrospective registry study within the German Cartilage Registry included 48 patients with symptomatic, radiologically confirmed hip dysplasia who underwent TO by the same specialist. The follow‐up rate at 24 months was 60.4% with a mean follow‐up time of 24 months. Outcomes measured included iHOT33 scores, quality of life, VAS for pain, satisfaction, perceived treatment benefit, and unemployment rate. Paired t‐tests and regression analysis (p < 0.05) were applied.

Preoperative iHOT33 scores averaged 46.9, increasing to 70.8 after 24 months (Δ 23.9), with notable improvement in the first 6 months (Δ 15.8). The “social” subdomain showed the greatest improvements (Δ 30 points), alongside improvements in quality of life and pain reduction (VAS). Postoperative angles (VCE 31° ± 4°, acetabular index 0° ± 3°) were within the normal range. No significant correlation was found between angle changes and iHOT33 scores, indicating benefits across dysplasia severities.

Triple‐osteotomy offers significant and rapid improvements in patient‐reported outcomes for individuals with hip dysplasia, particularly in enhancing social and sports‐related quality of life as measured by iHOT33 and other subjective assessments. Its potential advantages over Periacetabular‐osteotomy, especially in terms of early recovery, warrant further investigation through prospective, comparative studies to better define its role in hip‐preserving surgical strategies.

Level III.