Arthroscopic management with labral preservation, femoral osteoplasty, and capsular plication in patients with borderlin
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ORIGINAL PAPER
Arthroscopic management with labral preservation, femoral osteoplasty, and capsular plication in patients with borderline hip dysplasia. Results of a matched-cohort study at minimum two year follow-up Jesus Mas Martinez 1 & Javier Sanz-Reig 1 & Carmen Verdu Roman 1 & Enrique Martinez Gimenez 1 & Manuel Morales Santias 1 & David Bustamante Suarez de Puga 1 Received: 18 June 2020 / Accepted: 11 September 2020 # SICOT aisbl 2020
Abstract Purpose The purpose of this study was to assess intra-operative findings, surgical procedures, and outcomes in a cohort of patients with borderline hip dysplasia treated with arthroscopic labral repair, femoral osteoplasty, and capsular plication, and compare these outcomes with those of a rigorously matched control group without dysplasia. Methods Data were prospectively collected and retrospectively reviewed for patients with a lateral center-edge angle between 20 and 24° who underwent hip arthroscopy surgery between 2014 and 2018. Labral, chondral status, psoas impingement, ligamentum teres, and cam morphology were evaluated. Patient-reported outcomes (PROs) scores included modified Harris Hip Score (mHHS), Hip Outcome Score Activities of Daily Living Subscale (HOS-AVD) and Hip Outcome Score SportSpecific Subscale (HOS-SSS), and International Hip Outcome Tool-12 (IHOT-12). Clinical relevance was measured with the minimal clinical important difference (MCID), patient acceptable symptom state (PASS), and substantial clinical benefit (SCB). Results Twenty patients met the inclusion criteria. An age- and sex-matched control group of 40 patients was also selected. Arthroscopic intra-operative findings were similar between cohorts. At a mean follow-up of 50 months in the borderline hip dysplasia cohort, and 52 months in the control cohort, there was a significant improvement in PROs in both cohorts, and no significant differences could be detected at the latest follow-up. The difference in frequency of patients achieving the MCID, PASS, and SCB was not statistically significant between cohorts. Conclusion With strict patient selection criteria, hip arthroscopy may be a beneficial approach in patients with borderline hip dysplasia. Keywords Borderline dysplasia . Hip arthroscopy . Outcomes
Introduction Hip dysplasia produces overloading of the acetabulum, with progressive damage to the labrum and the articular cartilage. Periacetabular osteotomy (PAO) to improve acetabular coverage should be considered in these patients. However, this surgery associates morbidity, like significant blood loss, prolonged recovery times, fractures, or sciatic nerve injury. Level of Evidence: Level 3, cohort study. * Javier Sanz-Reig [email protected] 1
Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016 Alicante, Spain
And the lower incremental clinical improvement has been reported in patients with borderline dysplasia [1]. According to Wiberg [2], hips with lateral centre-edge angle (LCEA) > 25° were normal, and hips with LCEA < 25° were consid
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