Functional outcome and athletic level after arthroscopic repair followed by triple pelvic osteotomy in patients with labral tears resulting from acetabular dysplasia.

Abstract

Patients with acetabular dysplasia are at ahigher risk of developing symptomatic labral tears. Isolated treatments that address these pathologies are well established. Combined treatment with hip reorientation osteotomy using Bernese periacetabular osteotomy in addition to arthroscopic labral repair show good results. Studies that report the outcome in patients who received both arthroscopic labral repair and atriple pelvic osteotomy (TPO) are lacking. The aim of this study is to investigate the short to midterm functional outcome and activity level in these patients. This case series retrospectively included 8patients (2male, 6female) with acetabular dysplasia (lateral center-edge angle [LCEA] ≤ 25°) and alabral tear on magnetic resonance arthrography (MRA). All patients underwent arthroscopic labral repair followed by TPO after an average period of 3months (range 2-6). Average age at the time of surgery was 25years (range 15-37). Patients were followed up and the following main parameters were assessed: LCEA, modified Harris hip score (mHSS), Tegner score, UCLA score, patient satisfaction on ascale of 1-4. The mean follow-up was 19months (range 15-25). The mean LCEA increased from 18° to 37° (p < 0.0001). The mHSS improved from amean of 79 to 94 on final follow-up (p = 0.00123). The Tegner and UCLA scores had amedian of 4 and 5, respectively. The mean LCEA increased from 18° to 37° (p < 0.0001). The mean patient satisfaction was 3.6. Patients with evidence of alabral tear resulting from acetabular dysplasia benefit from arthroscopic repair followed by aTPO. The literature still lacks evidence that labral repair and reorientation osteotomy produce superior outcome compared to osteotomy alone. Treatment should consider clinical presentation in addition to radiological findings with emphasis on MRA.