FP7.5 Impact of Computer-Assisted Intraoperative Imaging on Correction Accuracy and 1-Year Outcomes After Periacetabular Osteotomy

Abstract ICLB07 - The Digital Surgeon: Practical Tools and Navigation Basics for Your Everyday Practice, Session Room 12 (BMCC Level 3), October 8, 2026, 14:00 - 16:00 Background The optimal acetabular positioning during periacetabular osteotomy (PAO) remains up for debate, and intraoperative assessment of correction has traditionally relied on surgeon judgment and visual assessment. Intraoperative computer-assisted imaging systems, such as Radlink, provide immediate feedback on fragment positioning. This study aimed to (1) evaluate whether the use of Radlink reduces variability in postoperative radiographic measurements, and (2) determine its impact on achieving clinically meaningful patient-reported outcome measures (PROMs) following PAO. Methods This retrospective review included 262 patients (92% female; mean age, 25.1 ± 8.0 years) who underwent PAO between 2018 and 2022 with minimum 1 year follow-up. Patients undergoing revision PAO or staged bilateral PAO with mixed Radlink use were excluded. Patients were grouped based on the use of intraoperative imaging: Radlink (n=147) versus no Radlink (n=115). PROMs, demographic, and radiographic data were collected. Radiographic parameters included lateral center-edge angle (LCEA) and anterior wall index (AWI), with predefined target ranges. The recently defined minimal clinically important difference (MCID) and patient acceptable symptom state (PASS) thresholds for PAO were used to assess patient outcomes. Results A greater proportion of Radlink patients achieved the target postoperative lateral center-edge angle (LCEA, 30–38°) compared with non-Radlink patients (83% vs 70%, p=0.01). A similar, non-significant difference was observed for anterior wall index (AWI, 0.30-0.51°) (50% vs 43%, p=0.21). Radlink patients demonstrated higher 1-year PROMs; the difference approached statistical significance for modified Harris Hip Score (88.9 ± 12.0 vs 84.1 ± 14.4, p=0.05) but not for International Hip Outcome Tool-12 (79.3 ± 20.1 vs 74.9 ± 22.9, p=0.43). A greater proportion of Radlink patients achieved an MCID or PASS threshold (93% vs 89%) at 1 year, without reaching statistical significance. Conclusion The use of computer-assisted intraoperative imaging software was associated with improved accuracy in achieving target acetabular correction, particularly for LCEA. While radiographic precision improved, this did not translate into significant differences in short-term PROMs. For an experienced surgeon, this software may not lead to drastic differences in outcomes, but appears to enhance correction accuracy and precision, which could be especially beneficial for less experienced surgeons during the learning curve.