Clinical Outcomes of Hip Arthroscopy in Radiographically Diagnosed Retroverted Acetabula

Hartigan, David E.; Perets, Itay; Walsh, John P.; Close, Mary R.; Domb, Benjamin G.

doi:10.1177/0363546516652615

Cited by 36 publications

(51 citation statements)

References 27 publications

(34 reference statements)

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“…[64][65][66] Hartigan et al reported a series of 78 patients (82 hips) with global retroversion that underwent arthroscopic treatment. 17 At minimum of 22-month followup (average 39 months), there was a significant improvement in HHS with no worsening of Tönnis grade in 15 hips, and only 1 hip had undergone total hip arthroplasty. At short-term follow-up, hip arthroscopy was an effective treatment for acetabular retroversion.…”

Section: Results Of Arthroscopic Procedures To Treat Acetabular Retromentioning

confidence: 89%

“…15,16 In contrast, acetabular retroversion is characterized by excess anterior coverage of the femoral head by the acetabulum resulting in femoroacetabular impingement (FAI) and subsequent joint damage. 17 Recent studies have compared results of surgical hip dislocation and PAO to treat acetabular retroversion 2 and investigated hip arthroscopy as a treatment of impingement. 17 As individuals with these conditions commonly present to orthopaedic surgeons, it is important to understand the appropriate nonsurgical and surgical options for these patients.…”

mentioning

confidence: 99%

“…17 Recent studies have compared results of surgical hip dislocation and PAO to treat acetabular retroversion 2 and investigated hip arthroscopy as a treatment of impingement. 17 As individuals with these conditions commonly present to orthopaedic surgeons, it is important to understand the appropriate nonsurgical and surgical options for these patients.…”

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confidence: 99%

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Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

et al. 2018

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Borderline hip dysplasia and acetabular retroversion are common radiographic findings in young individuals with and without hip pain. Orthopaedic surgeons should be knowledgeable about the radiographic findings, diagnosis, and appropriate nonsurgical and surgical treatment of these conditions. Borderline hip dysplasia is generally defined by a lateral center edge angle of Wiberg from 20 to 25° (some define as 18–25°) and is a cause of joint microinstability. The degree of soft tissue laxity can have significant implications for joint stability in patients with borderline hip dysplasia. The most common presenting symptoms are groin pain and lateral hip pain. Acetabular retroversion is defined by radiographic findings of crossover sign, ischial spine sign, and posterior wall sign. Individuals with symptomatic retroversion have a clinical presentation consistent with impingement, groin pain with flexion activities, and less commonly lateral hip pain. Physical therapy has been shown to improve symptoms in a subset of individuals with these conditions. There are multiple recent publications about arthroscopic treatment of patients with borderline hip dysplasia. These reports generally find that good short-term outcomes can be expected when using arthroscopic techniques that include labral preservation/repair and capsular plication. There are limited reports of periacetabular osteotomy as a treatment for borderline hip dysplasia. Publications focusing specifically on surgical treatment of acetabular retroversion are also infrequent. Periacetabular osteotomy has been shown to have superior long-term clinical outcomes to surgical hip dislocation with anterior rim trimming in patients with all three radiographic findings of retroversion. Arthroscopic treatment has been shown to have good short-term outcomes. Future work in the areas of borderline hip dysplasia and acetabular retroversion should focus on reporting long-term clinical follow-up of these surgical treatments and using computation techniques as a tool to determine appropriate surgical and nonsurgical treatment for each individual patient.

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Section: Results Of Arthroscopic Procedures To Treat Acetabular Retromentioning

confidence: 89%

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confidence: 99%

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Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

et al. 2018

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“…Because of the known increased incidence of osteoarthritis in hips with retroverted acetabula, this morphological variant is worthy of attention. 8 Hartigan et al 12 previously reported on the 2-year outcomes of 78 retroverted acetabula treated with hip arthroscopic surgery, describing an improvement in preoperative versus postoperative VAS (5.9 to 2.5), mHHS (65 to 81), HOOS-ADL (69 to 88), and HOOS-Sports (47 to 76) scores. Our results (VAS score decreased from 3.9 to 1.6, HOOS-ADL score increased from 67.3 to 92.3, and HOOS-Sports score increased from 38.9 to 78.7) are comparable with this previous series, with the additional finding that the improvements in PRO scores align with those observed in nonretroverted patients with pincer-type FAI treated in a similar fashion.…”

Section: Discussionmentioning

confidence: 99%

“… 29 , 32 Recent studies have shown that both hip arthroscopic surgery and anteverting PAO for the treatment of symptomatic acetabular retroversion can lead to significant improvements in patient-reported outcomes (PROs), with a minimal progression of osteoarthritis. 12 , 21 Hartigan et al 12 found that in their case series, the arthroscopic treatment of global acetabular retroversion had a 99% survivorship rate at 2 years, with a minor complication rate of only 3.6%. However, there has been no previous analysis of PROs after the arthroscopic treatment of global acetabular retroversion as compared with outcomes after the arthroscopic treatment of focal pincer-type FAI.…”

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confidence: 99%

Arthroscopic Treatment of Acetabular Retroversion With Acetabuloplasty and Subspine Decompression: A Matched Comparison With Patients Undergoing Arthroscopic Treatment for Focal Pincer-Type Femoroacetabular Impingement

Flores

Chambers

Borak

et al. 2018

Orthopaedic Journal of Sports Medicine

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Background:Global acetabular retroversion is classically treated with open reverse periacetabular osteotomy. Given the low morbidity and recent success associated with the arthroscopic treatment of femoroacetabular impingement (FAI), there may also be a role for arthroscopic treatment of acetabular retroversion. However, the safety and outcomes after hip arthroscopic surgery for retroversion need further study, and the effect of impingement from the anterior inferior iliac spine (subspine) in patients with retroversion is currently unknown.Hypothesis:Arthroscopic treatment for global acetabular retroversion will be safe, and patients will have similar outcomes compared with a matched group undergoing arthroscopic treatment for focal pincer-type FAI.Study Design:Cohort study; Level of evidence, 2.Methods:Patients undergoing hip arthroscopic surgery for symptomatic global acetabular retroversion were prospectively enrolled and compared with a matched group of patients undergoing arthroscopic surgery for focal pincer-type FAI. Both groups underwent the same arthroscopic treatment protocol. All patients were administered patient-reported outcome (PRO) measures, including the 12-item Short-Form Health Survey (SF-12) Physical Component Summary (PCS) and a Mental Component Summary (MCS), modified Harris Hip Score (mHHS), Hip disability and Osteoarthritis Outcome Score (HOOS), and visual analog scale (VAS) for pain preoperatively and at 1 year postoperatively.Results:There were no differences in age, sex, or body mass index between 39 hips treated for global acetabular retroversion and 39 hips treated for focal pincer-type FAI. There were no major or minor complications in either group. Patients who underwent arthroscopic treatment for global acetabular retroversion demonstrated similar significant improvements in postoperative PRO scores (scores increased by 17 to 43 points) as patients who underwent arthroscopic treatment for focal pincer-type FAI. Patients treated for retroversion who also underwent subspine decompression had greater improvement than patients who did not undergo subspine decompression for the HOOS-Pain (33.7 ± 15.3 vs 22.5 ± 17.6, respectively; P = .046) and HOOS–Quality of Life (49.7 ± 18.8 vs 34.6 ± 22.0, respectively; P = .030) scores.Conclusion:Arthroscopic treatment for acetabular retroversion is safe and provides significant clinical improvement similar to arthroscopic treatment for pincer-type FAI. Patients with acetabular retroversion who also underwent arthroscopic subspine decompression demonstrated greater improvements in pain and quality of life outcomes than those who underwent arthroscopic treatment without subspine decompression.

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Reverse Periacetabular Osteotomy

Wettstein

2020

Hip Preservation Surgery

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Clinical Outcomes of Hip Arthroscopy in Radiographically Diagnosed Retroverted Acetabula

Cited by 36 publications

References 27 publications

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

Diagnosis and Management of Borderline Hip Dysplasia and Acetabular Retroversion

Arthroscopic Treatment of Acetabular Retroversion With Acetabuloplasty and Subspine Decompression: A Matched Comparison With Patients Undergoing Arthroscopic Treatment for Focal Pincer-Type Femoroacetabular Impingement

Reverse Periacetabular Osteotomy

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