Arthroscopic Treatment of Labral Tears in Patients with Borderline Developmental Dysplasia of the Hip: A Retrospective Study with Mean 5.8 Years Follow-Up.

Abstract

ObjectiveTo retrospectively assess the mid‐term clinical and radiological results of hip arthroscopic treatment of labral tears in patients with borderline developmental dysplasia of the hip (BDDH).MethodsFrom January 2010 and December 2019, data were retrospectively reviewed for all patients who underwent arthroscopic surgery of the hip for the treatment of intra‐articular abnormalities. Only the Patients who had borderline developmental dysplasia (BDDH) were included. All operations were performed by two senior surgeons, the arthroscopic treatment including labral repair, labral debridement, minimal acetabuloplasty, femoroplasty and capsular closure. The evaluation consisted of pain evaluation (visual analog scale [VAS]), the modified Harris hip score (MHHS), range of motion, the radiological evaluation of plain film and MRI analysis of the hip joint. The plain film evaluation included anteroposterior views of the pelvis to assess lateral center‐edge angle (LCEA) and acetabular inclination (AI), frog‐leg lateral views of the hip to assess α angle.ResultsThere were 34 patients (36 hips) ultimately enrolled in this study. The follow‐up duration of the patients were minimal 2 years (average, 69.2 months) postoperatively. The patient group included seven men and 27 women, the mean age at the time of surgery was 30.9 years. The mean BMI was 22.3 kg/m2. From the pre‐operative status to the final follow‐up visit, mean mHHS score increased from 64.5 to 92.7, mean VAS score decreased from 6.8 to 1.3. All scores exhibited statistically significant differences (P < 0.001). The mean LCEA decreased from 22.9° to 22.7°, the mean AI decreased from 7.7° to 7.6°. Which all showed no significant differences compared with the final follow‐up to the pre‐operative status (P > 0.05). However, the mean α angle was significantly decreased from 48.3° to 40.1° (P < 0.001). We encountered no significant complications such as infection, deep venous thrombosis, fluid extravasation, or permanent nerve injury. One patient (2.94%) underwent revision periacetabular osteotomies (PAO) because of subluxation of the hip joint with permanent pain after 6 months failed conservative treatment.ConclusionArthroscopic treatment of labral tears in patients with BDDH may provide safe and durable favorable results at midterm follow‐up. The best outcome could be expected in patients with labral repair and closure of the capsule with strict patient selection criteria.