Editorial Commentary: Quantifying Anterior and Lateral Acetabular Coverage in Hip Dysplasia: What About Posterior Coverage?

Beaulé, Paul E.

doi:10.1016/j.arthro.2019.01.041

Cited by 10 publications

(11 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Arthroscopic LT debridement has resulted in good outcomes at short-term and midterm follow-up. 1,8,47 In 26 patients (27 hips 47 reached a similar conclusion in a match-controlled study of patients with complete LT tears. In that study, 18 patients with complete LT tears achieved significant and comparable improvement at 2-year follow-up compared with a group of patients with FAI and intact LTs.…”

Section: Discussionmentioning

confidence: 60%

“…Arthroscopic LT debridement has resulted in good outcomes at short-term and midterm follow-up. 1,8,47 In 26 patients (27 hips) with an average age of 24.4 years (range, 12-45 years), Amenabar and O’Donnell 1 reported significant improvement on the mHHS (from 65.2 ± 13.0 [range, 59.5-71.0] to 89.3 ± 11.6 [range, 84.2-94.5]; P < .05) and NAHS (from 66.2 ± 13.3 [range, 60.4-72.1] to 86.7 ± 11.0 [range, 81.9-91.5]; P < .05) after LT debridement and capsular plication. However, no information regarding acetabular coverage was provided.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, dysplasia is a complex tridimensional structural abnormality, and an isolated assessment based only on the LCEA may be oversimplistic. 8,51 Lastly, the decision to include LT tears ≥50% was arbitrary.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery

et al. 2020

View full text Add to dashboard Cite

Background: Hip arthroscopic surgery in patients with borderline dysplasia continues to be controversial. In addition, it has been suggested that ligamentum teres (LT) tears may lead to inferior short-term patient-reported outcomes (PROs) when compared with a match-controlled group. Purposes: (1) To report minimum 5-year PROs in patients with borderline dysplasia and LT tears who underwent hip arthroscopic surgery and (2) to compare these PROs to those of a matched-pair control group of patients with borderline dysplastic hips without LT tears. Study Design: Cohort study; Level of evidence, 3. Methods: Data were prospectively collected for patients who underwent hip arthroscopic surgery between September 2008 and August 2013. Patients were included if they had a preoperative diagnosis of borderline dysplasia (lateral center-edge angle [LCEA], 18°-25°) and had preoperative and minimum 5-year postoperative modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), and visual analog scale (VAS) for pain scores. Exclusion criteria were osteoarthritis of Tönnis grade >1, previous hip conditions, any previous ipsilateral hip surgery, or workers’ compensation status. There were 2 borderline dysplastic groups created. An LT tear group was matched 1:1 to a control group (no LT tear) with similar age, sex, body mass index (BMI), and laterality via propensity score matching. Significance was set at P < .05. Results: A total of 24 patients with an LT tear (24 hips) were matched to 24 patients without an LT tear (24 hips). There was no significant difference in age, sex, BMI, or laterality between groups. The mean age was 36.2 ± 17.2 and 34.9 ± 15.9 years for the control and LT tear groups, respectively ( P = .783). There were 17 (70.8%) and 16 (66.7%) female patients in the control and LT tear groups, respectively, and the mean preoperative LCEA was 23.3° and 22.2° in the control and LT tear groups, respectively. No differences were observed between groups in baseline PROs, intraoperative findings, or surgical procedures. LT debridement was performed in 17 (70.8%) patients in the LT tear group compared with 0 (0.0%) in the control group. Also, 5-year postoperative PROs were comparable in both groups, with the control group exhibiting superior Veterans RAND 12-Item Health Survey (VR-12) mental ( P = .041) and Short Form–12 (SF-12) mental ( P = .042) scores. Finally, hips with an intact LT were significantly more likely ( P = .022) to achieve the patient acceptable symptomatic state (PASS) for the mHHS (100.0% and 75.0%, respectively). No significant differences were present between the groups for the minimal clinically important difference (MCID) of the mHHS ( P = .140), MCID of the Hip Outcome Score–Sport-Specific Subscale (HOS-SSS) ( P = .550), or PASS of the HOS-SSS ( P = .390). Conclusion: After hip arthroscopic surgery, patients with borderline dysplasia and LT tears demonstrated favorable PROs at a minimum 5-year follow-up. Outcomes were similar to a matched-pair control group without LT tears, with the group with intact LTs showing higher VR-12 mental and SF-12 mental scores. Furthermore, patients with borderline dysplasia and intact LTs were significantly more likely to achieve the PASS for the mHHS.

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Hip dysplasia is a multiplex tridimensional structural pathology, and assessment based only on LCEA may be oversimplistic. 3 Moreover, patients with borderline dysplasia, defined as LCEA between 19° and 25°, were not excluded from the present study, which may introduce heterogeneity in the patient cohort. Although this is a propensity-matched control study, several variables (eg, generalized ligamentous laxity and femoral version) were not included into the matching design and may introduce potential confounding bias.…”

Section: Discussionmentioning

confidence: 99%

Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy: Midterm Outcomes With Propensity-Matched Control Group

et al. 2020

View full text Add to dashboard Cite

Background: Different options, from reverse (anteverting) periacetabular osteotomy to hip arthroscopy, have been proposed for surgical treatment of femoroacetabular impingement syndrome (FAIS) in the setting of acetabular retroversion. Purpose: (1) To report and analyze midterm patient-reported outcome scores (PROs) in patients with FAIS and labral tears in the setting of acetabular retroversion after isolated hip arthroscopy and (2) to compare these PROs with those of a propensity-matched control group without acetabular retroversion. Study Design: Cohort study; Level of evidence, 3. Methods: Prospectively collected data were retrospectively reviewed for patients who underwent hip arthroscopy for FAIS and labral tear treatment between June 2008 and March 2014. Inclusion criteria were as follows: acetabular retroversion, pre- and postoperative PROs for modified Harris Hip Score (mHHS), Non-arthritic Hip Score, Hip Outcome Score–Sports Specific Scale (HOS-SSS), and visual analog scale (VAS). Propensity score matching was utilized to identify a control group without acetabular retroversion matched 1:1 with similar age, sex, body mass index, acetabular and femoral head Outerbridge grade, preoperative lateral center-edge angle, and labral treatment. Patient acceptable symptomatic state (PASS) and/or minimal clinically important difference (MCID) for the mHHS, HOS-SSS, International Hip Outcome Tool–12, and VAS was calculated. Results: A total of 205 hips with acetabular retroversion were matched to a control group. The groups showed no difference in demographic variables. The retroversion group was composed of 139 female and 66 male hips, with a mean ± SD age of 23.81 ± 7.28 years and follow-up time of 65.24 ± 20.31 months. Intraoperative diagnostic data and procedures performed were similar between groups, except more femoroplasties were performed in the retroversion group. Significant improvements for the mHHS, Non-arthritic Hip Score, HOS-SSS, and VAS were seen for both groups at a mean 5-year follow-up. The proportion of patients who reached the PASS and MCID were similar. Conclusion: In the setting of FAIS and labral tears, patients with acetabular retroversion can be safely treated with advanced hip arthroscopic techniques without reverse (anteverting) periacetabular osteotomy in a high-volume surgeon’s hands. Patients with acetabular retroversion demonstrated favorable PROs at midterm follow-up. Furthermore, the proportion of patients reaching the MCID and PASS for several PROs were comparable with those of a propensity-matched control group without acetabular retroversion.

show abstract

“…In this study, acetabular retroversion is defined by the presence of a cross-over sign (COS), posterior-wall sign (PWS), and ischial spine sign. 1-4 These measurements were recently recommended in the Lisbon Agreement on Femoroacetabular Impingement Imaging for the evaluation of acetabular retroversion. 6…”

mentioning

confidence: 99%

Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy: Letter to the Editor

Zimmerer¹,

Sobau²

2020

Am J Sports Med

View full text Add to dashboard Cite

We read with interest the article by Maldonado et al 5 titled ''Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy Midterm Outcomes With Propensity-Matched Control Group,'' and would like to congratulate the authors for their study and the effort they put into it. However, we would be pleased to address a question to the authors. Figure 1 in their article shows a view of a supine anteroposterior (AP) pelvis to demonstrate the radiographic assessment. In this study, acetabular retroversion is defined by the presence of a cross-over sign (COS), posterior-wall sign (PWS), and ischial spine sign. 1-4 These measurements were recently recommended in the Lisbon Agreement on Femoroacetabular Impingement Imaging for the evaluation of acetabular retroversion. 6 To adequately assess an AP pelvis view, however, certain criteria were described. A neutral pelvic rotation is defined as the tip of the coccyx pointing toward the midpoint of the superior aspect of the symphysis pubis. Furthermore, a neutral pelvic tilt is defined as the distance of 3.2 cm between the upper border of the symphysis and the midportion of the sacrococcygeal joint for men and 4.7 cm for women. 7 This is crucial because the projected anatomy of the acetabulum and the corresponding radiographic measurements on an AP pelvis view depend directly on pelvic tilt and rotation during acquisition of the radiograph. Several studies have demonstrated that an increasing pelvic inclination (forward tilt) is associated with an increasing number of hips with COS and PWS, demonstrating an increase in the apparent rates of acetabular retroversion. 8-10 To recall Figure 1 of this study, it should be noted that it appears as if the pelvis is tilted significantly anterior, which may simulate acetabular retroversion. In particular, there seems to be an increased distance between the upper border of the symphysis and the midportion of the sacrococcygeal joint. Furthermore, the obturator foramina appear very narrow and not perfectly symmetrical.

show abstract

Editorial Commentary: Quantifying Anterior and Lateral Acetabular Coverage in Hip Dysplasia: What About Posterior Coverage?

Cited by 10 publications

References 14 publications

An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery

An Intact Ligamentum Teres Predicts a Superior Prognosis in Patients With Borderline Dysplasia: A Matched-Pair Controlled Study With Minimum 5-Year Outcomes After Hip Arthroscopic Surgery

Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy: Midterm Outcomes With Propensity-Matched Control Group

Hips With Acetabular Retroversion Can Be Safely Treated With Advanced Arthroscopic Techniques Without Anteverting Periacetabular Osteotomy: Letter to the Editor

Contact Info

Product

Resources

About