Arthroscopy of the hip for patients with mild to moderate developmental dysplasia of the hip and femoroacetabular impingement

Abstract

The purpose of this study was to determine patient-reported outcomes of patients with mild to moderate developmental dysplasia of the hip (DDH) and femoroacetabular impingement (FAI) undergoing arthroscopy of the hip in the treatment of chondrolabral pathology. A total of 28 patients with a centre-edge angle between 15° and 19° were identified from an institutional database. Their mean age was 34 years (18 to 53), with 12 female and 16 male patients. All underwent labral treatment and concomitant correction of FAI. There were nine reoperations, with two patients requiring revision arthroscopy, two requiring periacetabular osteotomy and five needing total hip arthroplasty. Patients who required further major surgery were more likely to be older, male, and to have more severe DDH with a larger alpha angle and decreased joint space. At a mean follow-up of 42 months (24 to 89), the mean modified Harris hip score improved from 59 (20 to 98) to 82 (45 to 100; p < 0.001). The mean Western Ontario and McMaster Universities Osteoarthritis Index score improved from 30 (1 to 61) to 16 (0 to 43; p < 0.001). Median patient satisfaction was 9.0/10 (1 to 10). Patients reported excellent improvement in function following arthroscopy of the hip. This study shows that with proper patient selection, arthroscopy of the hip can be successful in the young patient with mild to moderate DDH and FAI.

Femoral Morphology in the Dysplastic Hip: Three-dimensional Characterizations With CT

“…2) [6,13,27,34,43]; and (10) headneck offset ratio (HNOR) was measured by taking the femoral head-neck offset measurement and dividing by the femoral head diameter [6,10,34]. Hips with an alpha angle C 55°were classified as having coexisting cam morphology [16,31,37]. We further assessed subgroups to try to identify relationships between proximal femoral characteristics and head-neck offset abnormalities.…”

Successful Outcomes at Midterm Follow-up of Periacetabular Osteotomy Done for Mild Hip Dysplasia

“…Fukui et al similarly recently reported the results of 28 patients with mild-to-moderate hip dysplasia and concomitant femoroacetabular impingement (FAI) undergoing hip arthroscopy. 25 This was a select group of patients from the practice of the senior author of that paper that had either labral repair or reconstruction, with all other patients with labral debridement excluded. All these patients had radiographic signs of hip dysplasia, with half of them having signs of acetabular retroversion and combined femoral head neck abnormalities.…”

Microinstability of the hip: a previously unrecognized pathology

“…Hip arthroscopy has a dual role regarding the treatment of hip microinstability. The correction of borderline dysplastic characteristics, that may contribute to microinstability, in combination with the manipulation of soft tissues in and around the hip joint are responsible for the encouraging results that has already been reported in literature 49,50 . Intra-articular pathology, such as labral tears, cartilage defects and/or ligamentum teres abnormalities are often present in patients with hip microinstability.…”