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Hip arthroscopy and T-shaped capsular plication for the treatment of borderline dysplasia: a minimum 2-year follow-up

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Purpose

The aim of the study was to evaluate the clinical outcomes of patients treated arthroscopically for symptomatic borderline dysplasia of the hip (BHD) with a T-shaped capsular plication, with a minimum follow-up of 24 months.

Methods

Twenty-seven patients who had undergone hip arthroscopy and T-shaped capsular plication for symptomatic BHD were included in the study. All patients were clinically evaluated prior to surgery (T0) and at two consecutive follow-ups (T1: 12 ± 1.2 months; T2: 52.0 ± 23.2 months) using the visual analogue scale (VAS) pain score, the Hip Outcome Score in activities of daily living (HOS-ADL) and sport-specific subscale (HOS-SSS), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Short Form-12 in its physical (PCS) and mental component scores (MCS). We also evaluated the presence of correlations and analysed the possible differences between subgroups.

Results

We found a significant difference for HOS-ADL, HOS-SSS, VAS and WOMAC with the Friedman test for repeated measures through time points (p < 0.0001), but not for MCS. All clinical scores reported a significant improvement compared to the previous time point (p < 0.05), with the exception of HOS-SSS, for which p = 0.2570 between T1 and T2. The body mass index was positively correlated with preoperative VAS (R = 0.42857; p = 0.0257) and negatively correlated with PCS at T0 (R = − 0.40999; p = 0.0337) and with PCS (R = − 0.40491; p = 0.0362), MCS (R = − 0.45939; p = 0.0159) and WOMAC (R = − 0.40573; p = 0.0216) at T2. No complications were reported in our cohort.

Conclusions

The results of the current study confirm that patients with intra-articular hip pathology and concomitant BHD (LCEA 20°–25°) can benefit from arthroscopic treatment and that T-shaped capsular plication is one of the available options. Orthopaedic surgeons specialising in hip arthroscopy should consider arthroscopy for the treatment of symptomatic BHD for stabilising and strengthening the joint. Future studies should focus on finding out which type of patients can benefit most from this procedure.

Level of evidence IV

Prospective Case Series

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Authors and Affiliations

  1. Humanitas Clinical and Research Center, Milan, Rozzano, Italy

    Federico Della Rocca & Vincenzo Di Francia

  2. Orthopedic Clinic, University Hospital of Parma, Parma, Italy

    Paolo Schiavi

  3. IRCCS Istituto Ortopedico Galeazzi, Via Galeazzi 4, 20161, Milan, Italy

    Riccardo D’Ambrosi

Authors
  1. Federico Della Rocca
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  2. Vincenzo Di Francia
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  3. Paolo Schiavi
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  4. Riccardo D’Ambrosi
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All authors contributed equally.

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Correspondence to Riccardo D’Ambrosi.

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One of the authors is a paid consultant for Smith and Nephew and Zimmer Biomet.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Appendix

Appendix

See Tables 5 and 6.

Table 5 Comparison between patients based on age
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Table 6 Comparison between patients based on BMI
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Della Rocca, F., Di Francia, V., Schiavi, P. et al. Hip arthroscopy and T-shaped capsular plication for the treatment of borderline dysplasia: a minimum 2-year follow-up. Eur J Orthop Surg Traumatol 32, 449–458 (2022). https://doi.org/10.1007/s00590-021-02997-z

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