• PURPOSE
    • To summarize and evaluate the surgical technique, patient-reported outcomes (PROs), and complications of combined periacetabular osteotomy (PAO) and hip arthroscopy for the treatment of hip dysplasia and intra- and extra-articular hip pathology, respectively.
  • METHODS
    • Clinical studies evaluating outcomes of simultaneous combined hip arthroscopy and PAO procedures performed under the same anesthesia event were identified in PubMed, Embase, and The Cochrane Library per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines up to October 10, 2024. PROs, complications, intraoperative procedures, radiographic parameters, and demographic factors were assessed. Study quality and bias were assessed using the modified Coleman score and Methodological Index for Non-Randomized Studies (MINORS). Studies assessing hip arthroscopy and PAO not performed under the same anesthesia event were excluded.
  • RESULTS
    • Twelve studies with 730 hips (612 female and 118 male) were included, with average follow-up time ranging from 1.7 to 12.8 years. Eleven studies reported PROs, and all studies that compared postoperative and baseline outcomes reported a statistically significant improvement in modified Harris Hip Score, Hip Outcome Score-Activities of Daily Living, Hip Outcome Score-Sport, and visual analog scale for pain postoperatively compared to baseline. The modified Harris Hip Score, visual analog scale for pain, and Non-Arthritic Hip Score ranged from 55 to 72 preoperatively to 82 to 90 postoperatively, 5.1 to 6 preoperatively to 1.9 to 3 postoperatively, and 57 to 61 preoperatively to 80 to 90 postoperatively, respectively. Minimal clinically important difference was reported in 4 studies and patient acceptable symptom state in 2 studies. Thirty-three hips (4.5%) experienced complications, and 8 hips (1%) converted to total hip arthroplasty. The median modified Coleman methodology score was 59 (Range: 43-65), and the median MINORS score was 12 (Range: 11-14) for noncomparative studies and 20.5 (Range: 19-22) for comparative studies.
  • CONCLUSIONS
    • Combined hip arthroscopy and PAO results in statistically significant improvement in PROs, low complication rates, and low conversion to arthroplasty at short- to medium-term follow-up.
  • LEVEL OF EVIDENCE
    • Level IV, systematic review of Level III and IV studies.