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Lookup NU author(s): Dr Richard Holleyman, Ajay MalviyaORCiD
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND).
© The Author(s) 2025. This article is distributed under the terms of the Creative Commons Attribution-NoDerivs 4.0 License (https://creativecommons.org/licenses/by-nc-nd/4.0/) which permits any use, reproduction and distribution of the work as published without adaptation or alteration, provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).Background: Periacetabular osteotomy (PAO) is an established treatment for symptomatic developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI; principally acetabular retroversion) in adults who are commonly of reproductive age.Purpose:To describe the effect of PAO on patient-reported sexual function (SF) using data from the UK Non-Arthroplasty Hip Registry (NAHR).Study Design:Cohort study: Level of evidence, 3.Methods:Adult patients who underwent isolated PAO between January 2012 and July 2022 were extracted from the NAHR. The EuroQol-5 Dimensions (EQ-5D) and International Hip Outcome Tool 12 (iHOT-12) questionnaires were collected preoperatively and at 6 and 12 months postoperatively. This included responses to 2 questions from the iHOT-12 questionnaire relevant to SF: (1) “Are questions about SF relevant to you?” and (2) “How much trouble do you have with sexual activity because of your hip?” (0 = severe; 100 = none).Results:A total of 773 patients (median age, 29 years (IQR, 23-37), 92.5% female) who underwent PAO for DDH (n = 703; 90.9%) or FAI (n = 70; 9.1%) were identified after exclusions. Of iHOT-12 respondents, 88.2% indicated that SF was relevant to them. Baseline median iHOT-12 SF scores were 33 (IQR, 18-53) for female and 73 (IQR, 36-90) for male patients. Female iHOT-12 SF improved by a mean of +19.9 points (95% CI, 16.5-23.2) at 6 months (P < .0001), with continued improvement to +26.4 points (95% CI, 23.0-29.8) at 12 months (P < .0001) versus preoperative SF scores. At 12 months, median iHOT-12 SF scores were 70 (IQR, 40-90) and 89 (IQR, 70-99) for female and male patients, respectively. Preoperative SF scores were significantly lower (P = .001) in patients who underwent PAO for indication of FAI (female median score 22; IQR, 10-38) compared with DDH (female median score: 34; IQR, 18-54); however, both indications saw significant improvement in SF scores at 12 months. iHOT-12 SF scores improved for 77.1% and worsened for 19.1% of female respondents with DDH. A strong positive association was seen between health-related quality of life (EQ-5D) and SF scores, and there was significant improvement in SF across studied ages.Conclusion:PAO was associated with significant improvement in patient-reported SF for the majority of patients. Some patients may have trouble with sexual activity even 1 year after PAO for DDH, with almost 20% reporting poorer SF compared with preoperative baseline.
Author(s): Holleyman RJ, Smith C, Baig K, Bankes M, Witt J, Judge A, Khanduja V, Malviya A
Publication type: Article
Publication status: Published
Journal: Orthopaedic Journal of Sports Medicine
Year: 2025
Volume: 13
Issue: 6
Online publication date: 25/06/2025
Acceptance date: 17/02/2025
Date deposited: 18/08/2025
ISSN (print): 2325-9671
ISSN (electronic): 2325-9671
Publisher: Sage Publications Ltd
URL: https://doi.org/10.1177/23259671251341475
DOI: 10.1177/23259671251341475
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