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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

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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 Sport-Specific 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.

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Authors and Affiliations

  1. Hip Unit, Department of Orthopedic Surgery, HLA Clinica Vistahermosa, Av de Denia 76, 03016, Alicante, Spain

    Jesus Mas Martinez, Javier Sanz-Reig, Carmen Verdu Roman, Enrique Martinez Gimenez, Manuel Morales Santias & David Bustamante Suarez de Puga

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  1. Jesus Mas Martinez
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Correspondence to Javier Sanz-Reig.

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The Institutional Review Board approved the study, and all participants gave written informed consent to participate

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The authors declare that they have no conflict of interest.

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Level of Evidence: Level 3, cohort study.

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Mas Martinez, J., Sanz-Reig, J., Verdu Roman, C. et al. 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. International Orthopaedics (SICOT) 44, 2567–2575 (2020). https://doi.org/10.1007/s00264-020-04810-8

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