Arthroscopic Capsular Plication and Labral Preservation in Borderline Hip Dysplasia

Domb, Benjamin G.; Stake, Christine E.; Lindner, Diana; El-Bitar, Youssef; Jackson, Timothy J.

doi:10.1177/0363546513499154

Cited by 288 publications

(91 citation statements)

References 31 publications

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“…Two of these studies reported the outcomes of arthroscopic treatment [12, 19] and, combined with four additional studies [20–23], a total of six studies reported subjective and/or objective results. All studies were Level IV (Case series) studies and thus formal quality scoring for individual studies was not performed.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies from one institution were included for review of arthroscopic findings as there was no overlap of the patient cohorts [12, 24]. Another institution first reported the arthroscopic findings and outcome [21] and later reported only the arthroscopic finding with a larger cohort [25] which overlap the patient with the previous study.…”

Section: Resultsmentioning

confidence: 99%

“…[20]IV, Case Series36 (34)12:22Dysplastic40 (12–84)Labrum debridement performed in all hips

Arthroscopy performed specifically for labrum repair and/or excision were followed

9 hips had early arthritis

Kalore and Jiranek [23]IV, Prognostic study506:44Borderline dysplasia33 (12–65)Labrum tear -> repair (50%), debridement (50%)Results were compared between borderline and adequate acetabular coverage, debridement versus repairDomb et al. [12]IV, Case Series22 (22)4:18Borderline dysplasia27.5 (17-39) Labrum tear -> repair without detachment (21 hips)Lt tear -> debridement (1 hip)Unstable cartilage lesion -> chondroplastyPincer lesion -> minimal rim resectionCapsular plication was done in all cases …”

Section: Discussionmentioning

confidence: 99%

“…[20], 2009Failed to control symptoms in 67%

Functional outcome (Short form 36, SUSHI) at 2 years: 76

Accelerated arthritis (39%)

Migration of femoral head (36%)

Subsequent arthroscopy: 3

Periacetabular osteotomy: 6

Femoroacetabular osteoplasty: 7

THA: 3

Labral excision in symptomatic dysplasia can have detriemental effectKalore and Jiranek [23]HOOS shows no significant difference between borderline and adequate coverage, labral debridement versus repairReoperation: 15

Reoperation rate is higher in patients with borderline acetabular coverage,

Borderline dysplasia with labral debridement result in poor prognosis

Domb et al. [12] VAS: 5.8 -> 2.9Patient satisfaction: 8.4 mHHS: 69.0 -> 86.2HOS-ADLS: 72.9 -> 89.6HOS-SSS: 49.0 -> 77NAHS: 68.6 -> 85.9 3 hips progress from Tonnis grade 0–1Revision: 2Mild dysplasia can be successfully treated with arthroscopy when the treatment aimed at instabilitySUSHI, Super Simplified Hip Score; HOOS, Hip Dysfunction and Osteoarthritis Outcome Score.…”

Section: Discussionmentioning

confidence: 99%

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The role of arthroscopy in the dysplastic hip—a systematic review of the intra-articular findings, and the outcomes utilizing hip arthroscopic surgery

Lee

Wang

et al. 2016

J Hip Preserv Surg

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Acetabular dysplasia is one of the most common sources of hip arthritis. With the recent innovation in hip arthroscopy, the question has been raised whether arthroscopy can be used to treat dysplastic hip conditions. The purposes of this systematic review are (i) describe the prevalence of intra-articular pathologies and (ii) report the outcomes of dysplastic hip treatment with hip arthroscopy as a sole treatment. Medical databases were searched for articles including arthroscopic findings and treatment of dysplastic hip with predetermined criteria. PubMed, Ovid database and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched up until 7 January 2015. Two reviewers independently assess the eligibility of retrieved studies using titles, abstracts and full-text articles. Thirteen studies were eligible to be included for the systematic review. Overall, labral tear was the most common pathology with a prevalence rate of 77.3%. All of the four studies describing arthroscopic treatment for only borderline dysplasia reported favorable outcome. With regard to more severely dysplastic hips, two out of three studies reported acceptable outcomes while one study reported negative results. This review indicates that intra-articular pathology is commonly observed in symptomatic dysplastic hips with a labral tear being the most common pathology. Arthroscopic treatment of borderline dysplasia could provide benefits whereas treatment of more dysplastic hips is controversial. Nevertheless, there is a lack of evidence for using arthroscopy alone in hips with a center edge angle <20°. Level IV, systematic review of Level IV studies.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…[20]IV, Case Series36 (34)12:22Dysplastic40 (12–84)Labrum debridement performed in all hips

Arthroscopy performed specifically for labrum repair and/or excision were followed

9 hips had early arthritis

Section: Discussionmentioning

confidence: 99%

“…[20], 2009Failed to control symptoms in 67%

Functional outcome (Short form 36, SUSHI) at 2 years: 76

Accelerated arthritis (39%)

Migration of femoral head (36%)

Subsequent arthroscopy: 3

Periacetabular osteotomy: 6

Femoroacetabular osteoplasty: 7

THA: 3

Reoperation rate is higher in patients with borderline acetabular coverage,

Borderline dysplasia with labral debridement result in poor prognosis

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

The role of arthroscopy in the dysplastic hip—a systematic review of the intra-articular findings, and the outcomes utilizing hip arthroscopic surgery

Lee

Wang

et al. 2016

J Hip Preserv Surg

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show abstract

“…Byrd and Jones [44] debrided the torn labrum and reported an improved Harris hip score at 27 months. Domb et al [45] presented a series in which arthroscopic capsular plication and labral preservation were performed in patients with a CEA of 18-25°. He reported 77% good to excellent results at an average follow-up of 27 months.…”

Section: Specific Disordersmentioning

confidence: 99%

The use of hip arthroscopy in the management of the pediatric hip

Roy

2015

J Hip Preserv Surg

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Arthroscopy of the pediatric hip began in 1977 with a publication by Gross. Interest was relatively slow to develop in the 1980s and 1990s. Coupled with the success of hip arthroscopy in the adult, interest heightened in applying the procedure to a variety of pediatric hip disorders, given that the alternative was an open surgical hip dislocation. The success of this initial group of pediatric hip arthroscopist’s has further expanded the application of hip arthroscopy as the primary or adjunct procedure for the management of intra-articular problems of the pediatric hip.

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Three‐dimensional hip joint congruity evaluation of the borderline dysplasia: Zonal‐acetabular radius of curvature

Irie

Orías

Nho

et al. 2020

Journal Orthopaedic Research

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In theory, a hemispherical acetabulum provides the ideal hip congruity in any hip position. However, it remains unknown how the three‐dimensional acetabular morphology of borderline dysplastic and frank dysplastic hips compare to normal hips. This study inquires if borderline dysplastic zonal‐acetabular curvatures in the anterior, superior, and posterior zones are different from normal or dysplastic hips three‐dimensionally. One‐hundred and fifteen hips, grouped as control (25°≤ LCEA <40°), 36 hips; borderline (20°≤ LCEA <25°), 32 hips; dysplasia (LCEA ≤20°), 47 hips were analyzed. The radii of acetabular curvature for the anterior, superior, and posterior zones were calculated as the zonal‐acetabular radius of curvature (ZARC). The mean acetabular roof obliquity of the borderline (10.6 ± 4.3 [SD]°) was significantly larger than the control (3.0° ± 5.4°; P < .001) and smaller than the dysplasia (19.3° ± 5.7°; P < .001). Although the mean acetabular anteversion angle of the borderline (21.3° ± 3.7°) was significantly larger than control (17.9 ± 3.5°; P = .001), that of the borderline was not different from the dysplasia (23.3° ± 4.0°; P = .053). The mean anterior ZARC in the borderline (29.8 ± 2.6 mm) was significantly larger than the control (28.0 ± 2.2 mm; P = .011) and smaller than the dysplasia (31.5 ± 2.7 mm; P = .009). The mean superior ZARC in the borderline (25.7 ± 3.0 mm) was not different from the control (25.9 ± 2.2 mm; P = .934) or the dysplasia (25.8 ± 2.5 mm; P = .991). Although the mean posterior ZARC in the borderline (27.2 ± 2.5 mm) was not different from the control (26.4 ± 1.9 mm; P = .455), that of the borderline group was significantly smaller than the dysplasia (30.4 ± 3.3 mm; P < .001); that is, the severity of lateral under‐coverage affects the anterior and/or posterior zonal‐acetabular curvature.

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Arthroscopic Capsular Plication and Labral Preservation in Borderline Hip Dysplasia

Cited by 288 publications

References 31 publications

The role of arthroscopy in the dysplastic hip—a systematic review of the intra-articular findings, and the outcomes utilizing hip arthroscopic surgery

The role of arthroscopy in the dysplastic hip—a systematic review of the intra-articular findings, and the outcomes utilizing hip arthroscopic surgery

The use of hip arthroscopy in the management of the pediatric hip

Three‐dimensional hip joint congruity evaluation of the borderline dysplasia: Zonal‐acetabular radius of curvature

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