Abstract
Acetabular dysplasia is one of the most common sources of hip arthritis. With the recent innovation in hip arthroscopy, the question has been raised whether arthroscopy can be used to treat dysplastic hip conditions. The purposes of this systematic review are (i) describe the prevalence of intra-articular pathologies and (ii) report the outcomes of dysplastic hip treatment with hip arthroscopy as a sole treatment. Medical databases were searched for articles including arthroscopic findings and treatment of dysplastic hip with predetermined criteria. PubMed, Ovid database and CINAHL (Cumulative Index to Nursing and Allied Health Literature) were searched up until 7 January 2015. Two reviewers independently assess the eligibility of retrieved studies using titles, abstracts and full-text articles. Thirteen studies were eligible to be included for the systematic review. Overall, labral tear was the most common pathology with a prevalence rate of 77.3%. All of the four studies describing arthroscopic treatment for only borderline dysplasia reported favorable outcome. With regard to more severely dysplastic hips, two out of three studies reported acceptable outcomes while one study reported negative results. This review indicates that intra-articular pathology is commonly observed in symptomatic dysplastic hips with a labral tear being the most common pathology. Arthroscopic treatment of borderline dysplasia could provide benefits whereas treatment of more dysplastic hips is controversial. Nevertheless, there is a lack of evidence for using arthroscopy alone in hips with a center edge angle <20°. Level IV, systematic review of Level IV studies.
Highlights
Developmental dysplasia of the hip is one of the most common reasons leading to symptomatic hip arthritis [1]
This review indicates that intra-articular pathology is commonly observed in symptomatic dysplastic hips with a labral tear being the most common pathology
MATERIALS AND METHODS The online database search was made on 23 November 2014, with keywords ‘dysplastic’, ‘dysplasia’, ‘DDH’, ‘under coverage’, ‘hypoplasia’, ‘hip’, ‘acetabular’, ‘arthroscopy’ and ‘osteotomy’ using PubMed, Ovid database, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) from the database inception to the search date by two authors independently
Summary
Developmental dysplasia of the hip is one of the most common reasons leading to symptomatic hip arthritis [1]. Various methods have been proposed to minimize the problems potentially resulting from abnormal hip joint contact pressure generated by the lack of femoral head coverage. The resultant altered hip biomechanics can cause labral tears, chondral lesions, ligamentum teres (LT) injuries, hip instability or impingement [2, 9,10,11,12]. This can lead to degenerative hip disease that may necessitate joint replacement [13,14,15,16].
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