Abstract
PurposeThe aim is to compare the results of isolated hip arthroscopy in patients with borderline dysplasia with Lateral center edge angle (LCEA) between 18° and 25° with a control group of patients with normal LCEA (> 25°).MethodsFifty hip arthroscopies performed in 45 patients were retrospectively evaluated. Exclusion criteria were: age > 40, hip arthritis > grade 2 according to Tonnis classification, femoral head avascular necrosis, pediatric’s orthopaedics conditions and true dysplasia with LCEA < 18°.Two groups were identified: group A with 15 hips with LCEA between 25° and 18° and Group control B made of 35 hips with LCEA > 25°.ResultsThe groups were homogeneous for demography and pre-operative WOMAC and HOOS. Osteoplasty for CAM were performed in 100% of patients in both groups, only in 12 hips (34.4%) in group B we had both femoral and acetabular osteoplasty. Labral repair was performed in 86% of patients in group A, in 60% of patients in group B, capsular plication in 93% of group A, in 5% of case of group B. WOMAC and HOOS statically significant improved in both groups at final follow-up (24 months). No cases in both groups required conversion to total hip arthroplasty.Clinical outcomes of study group were comparable to the control group.ConclusionEven if the present small series is not conclusive, we suggest isolated arthroscopic management of patients with FAI and LCEA between 18° and 25°, but capsular plication and careful labral management are strongly recommended.Level of evidenceLevel IV.
Highlights
Hip arthroscopy is considered the technique of choice in the treatment of femoro-acetabular impingement (FAI) or labral tears, but its use in the treatment of mild hip developmental dysplasia (DDH) is under debate [8]
In patients with lateral center edge angle (LCEA) between 18° and 25° the labrum and capsule seem to have a relevant role in maintaining hip stability, and hip arthroscopy should play a relevant role in preventing chondrolabral degeneration in this subset of patients [2]
The hips were divided in two major groups: in the study group or Group A, we considered patients with an LCEA between 25° and 18°, and in the control group or Group B, there were patients with a LCEA > 25° (Table 1)
Summary
Hip arthroscopy is considered the technique of choice in the treatment of femoro-acetabular impingement (FAI) or labral tears, but its use in the treatment of mild hip developmental dysplasia (DDH) is under debate [8]. Pelvic osteotomies are technically demanding, complications may be expected in as many as 15% of cases and noticeable rates of conversion to Tassinari et al Journal of Experimental Orthopaedics (2021) 8:112 total hip arthroplasty (THA) have been reported in some series [1, 9, 12]. They are invasive procedures and not always well accepted especially by younger patients. Meticulous surgical techniques is mandatory in such cases, because iatrogenic instability, joint subluxation and premature chondrolabral derangement have been reported [1, 4, 6, 16]
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