2021 ISAKOS Biennial Congress Paper
Achieving Successful Outcomes In High-Level Athletes With Borderline Hip Dysplasia Undergoing Hip Arthroscopy With Capsular Plication And Labral Preservation: A Propensity Matched Controlled Study
Andrew Jimenez, MD, Chicago, Illinois UNITED STATES
Peter Monahan, BS, Des Plaines, Illinois UNITED STATES
Kara Miecznikowski, BS, Des Plaines, IL UNITED STATES
Benjamin Saks, MD, Exeter, New Hampshire UNITED STATES
Hari Krishna Ankem, MD, Louisville, KENTUCKY UNITED STATES
Payam William Sabetian, MD, Guatemala, Guatemala GUATEMALA
Ajay C. Lall, MD, MS, FAAOS, Paramus, New Jersey UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES
American Hip Institute Research Foundation, Des Plaines, IL, UNITED STATES
FDA Status Cleared
Summary
High-Level Athletes with Borderline Hip Dysplasia Outcomes
Abstract
Background
Return to sport (RTS) and patient-reported outcomes (PROs) after hip arthroscopy in athletes with borderline hip dysplasia (BD) has not been established.
Purpose
(1) To report minimum 2-year PROs and RTS rates in high-level athletes with BD
10 who underwent hip arthroscopy for labral pathology in the setting of microinstability and (2) to compare clinical results with a matched control group of athletes with normal acetabular coverage.
Study Design: Cohort study; Level of evidence, 3.
Methods
Data were reviewed for surgeries performed between November 2012 and July 2018. Patients were considered eligible if they received a primary hip arthroscopy in the setting of borderline dysplasia [lateral center-edge angle (LCEA) 18-25°] and competed in high-school, collegiate, or professional sports. Inclusion criteria included preoperative and minimum 2-year follow-up scores for the modified Harris Hip Score (mHHS), Non-arthritis Hip Score (NAHS), Hip Outcome Score-Sport Specific Subscale (HOS-SSS), and visual analog scale for pain (VAS). BD athletes were matched to a control group of athletes with normal acetabular coverage (LCEA 25°- 40°).
Results
A total of 65 patients with BD were included in the study with a mean follow-up of 47.5 ± 20.4 months. Athletes with BD showed significant improvement in all outcome measures recorded, demonstrated high RTS rates (80.7%), and achieved PASS/MCID for mHHS at high rates (MCID: 86.2%, PASS: 90.8%). When compared to a propensity matched control group with normal acetabular coverage, capsular plication was performed more commonly in the BD athletes (P = .037). PROs, RTS rate, and PASS/MCID rates were similar between the BD and control groups (P > .05).
Conclusion
High-level athletes with BD who undergo primary hip arthroscopy for labral pathology in the setting of microinstability may expect favorable outcomes with capsular plication and labral preservation. These results were comparable to the control group of athletes with normal coverage