2015 ISAKOS Biennial Congress ePoster #811

Arthroscopic Hip Surgery for Borderline Dysplasia-Surgical Outcomes Compared With Cohort After Arthroscopic FAI Correction

Junya Shimizu, MD, Sapporo JAPAN
Mitsunori Kaya, MD, Sapporo JAPAN
Kenji Tateda, MD, Sapporo, Hokkaido JAPAN
Satoshi Nagoya, Prof., Sapporo, Hokkaido JAPAN
Toshihiko Yamashita, MD, PhD, Sapporo, Hokkaido JAPAN

Department of Orthopaedic Surgery, Sapporo Medical University School of Medicine, Sapooro, Hokkaido, JAPAN

FDA Status Cleared

Summary: Arthroscopic hip surgery for borderline dysplasia yielded significantly improved outcome measures, but these were inferior to those after arthroscopic FAI corrective surgery.

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Abstract:

Background

There are limited data reporting outcomes after arthroscopic surgery for borderline dysplasia. The purpose of the current study was to evaluate outcomes after arthroscopic hip surgery for borderline dysplasia and compare the results to those of the arthroscopic FAI correction. The hypothesis of the current study was that arthroscopic surgery for borderline dysplasia results in improved outcomes, but they are inferior to those of arthroscopic surgery for FAI.

Methods

Patients who underwent hip arthroscopic surgery for borderline dysplasia were reviewed. Pathomorphological findings, intraoperative findings, and preoperative and postoperative modified Harris Hip Score (MHHS) were evaluated. Outcomes after arthroscopic surgery for borderline dysplasia were compared with outcomes of a cohort who underwent arthroscopic FAI correction.

Results

A total of 29 patients (29 hips) with a mean age of 46.7 years underwent hip arthroscopic surgery (mean follow-up, 12.1 months). The labrum was debrided (1 hip), repaired (28 hips). The mean improvement in outcome scores was 28.7 points on the modified Harris hip score (pre-operative=55.3 vs postoperative=84.0; P<.001, 95%CI; -37.2 to -20.2). Four cases with borderline dysplasia (55, 50, 59 and 46 years old) had progressed to total hip arthroplasty. The results of arthroscopic hip surgery for the patients with borderline dysplasia were compared to those of the patients with FAI. An improvement of 38.0 point on modified Harris hip score (pre-operative=55.8 vs postoperative=93.8; P<.001, 95%CI; -43.2 to -32.7) was noted after arthroscopic FAI correction. Most recent modified Harris score of the patients with borderline dysplasia was significantly poor compared with those of FAI (P=.013, 95%CI; 2.15 to 17.5)

Conclusion

Arthroscopic hip surgery for borderline dysplasia yielded significantly improved outcome measures, but these were inferior to those after arthroscopic FAI corrective surgery. Age older than 50 years old was risk factor for arthroscopic hip surgery to the patients with borderline dysplasia. Although surgical outcomes for borderline dysplasia was satisfactory, some skeletal modification (e.g. arthroscopic surgery plus shelf acetabuloplasty) may be necessary for the further improvement.