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Hip Arthroscopy of a Painful Hip with Borderline Dysplasia.

Abstract

Purpose

Hip arthroscopy has been considered for treating hip dysplasia; however, its efficacy is still a matter of controversy. Here, we report outcomes of patients with borderline dysplasia treated with a contemporary hip arthroscopy technique.

Materials and Methods

Forty-seven hips with borderline hip dysplasia were treated using hip arthroscopy. Patients underwent procedures to correct torn labrums or ligamentum teres with additional procedure on the acetabular capsule. Patient outcomes were assessed using visual analogue scale (VAS), modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS) and patient satisfaction. Risk factors for poor prognosis were also investigated.

Results

The mean follow up period was 25.9 months. At the last follow up, mean VAS score decreased from 6.1±1.6 to 3.5±2.8 (P=0.016). The mHHS and NHAS at the last follow up improved from 61.0±7.6 to 78.6±19.5 (P=0.001) and 62.1±7.5 to 80.0±18.5 (P=0.002), respectively. While significant improvement was observed in all patient reported outcome measures tested, 19 (40.4%) hips indicated that "the operation was unsatisfactory." The only factor shown to influence outcomes was preoperative VAS (i.e., worse scores potentially an indicator of poor outcomes).

Conclusion

The results of the current study indicate that arthroscopic management may be beneficial for a subset of patients with borderline dysplasia; however, the dissatisfaction rate associated with this treatment approach may be as high as 40%. The poor preoperative pain score appears to be the sole indicator for poor outcomes.

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  • Authors+Show Affiliations

    ,

    Department of Orthopaedic Surgery, Chonbuk National University Medical School, Jeonju, Korea.

    ,

    Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Korea.

    ,

    Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Korea.

    Department of Orthopaedic Surgery, School of Medicine, Chosun University, Gwangju, Korea.

    Source

    Hip & pelvis 31:2 2019 Jun pg 102-109

    Pub Type(s)

    Journal Article

    Language

    eng

    PubMed ID

    31198777

    Citation

    Yoon, Sun Jung, et al. "Hip Arthroscopy of a Painful Hip With Borderline Dysplasia." Hip & Pelvis, vol. 31, no. 2, 2019, pp. 102-109.
    Yoon SJ, Lee SH, Jang SW, et al. Hip Arthroscopy of a Painful Hip with Borderline Dysplasia. Hip Pelvis. 2019;31(2):102-109.
    Yoon, S. J., Lee, S. H., Jang, S. W., & Jo, S. (2019). Hip Arthroscopy of a Painful Hip with Borderline Dysplasia. Hip & Pelvis, 31(2), pp. 102-109. doi:10.5371/hp.2019.31.2.102.
    Yoon SJ, et al. Hip Arthroscopy of a Painful Hip With Borderline Dysplasia. Hip Pelvis. 2019;31(2):102-109. PubMed PMID: 31198777.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Hip Arthroscopy of a Painful Hip with Borderline Dysplasia. AU - Yoon,Sun Jung, AU - Lee,Sang Hong, AU - Jang,Se Woong, AU - Jo,Suenghwan, Y1 - 2019/05/30/ PY - 2019/03/10/received PY - 2019/04/28/revised PY - 2019/05/02/accepted PY - 2019/6/15/entrez PY - 2019/6/15/pubmed PY - 2019/6/15/medline KW - Arthroscopy KW - Borderline dysplasia KW - Capsule KW - Labrum KW - Round ligament SP - 102 EP - 109 JF - Hip & pelvis JO - Hip Pelvis VL - 31 IS - 2 N2 - Purpose: Hip arthroscopy has been considered for treating hip dysplasia; however, its efficacy is still a matter of controversy. Here, we report outcomes of patients with borderline dysplasia treated with a contemporary hip arthroscopy technique. Materials and Methods: Forty-seven hips with borderline hip dysplasia were treated using hip arthroscopy. Patients underwent procedures to correct torn labrums or ligamentum teres with additional procedure on the acetabular capsule. Patient outcomes were assessed using visual analogue scale (VAS), modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS) and patient satisfaction. Risk factors for poor prognosis were also investigated. Results: The mean follow up period was 25.9 months. At the last follow up, mean VAS score decreased from 6.1±1.6 to 3.5±2.8 (P=0.016). The mHHS and NHAS at the last follow up improved from 61.0±7.6 to 78.6±19.5 (P=0.001) and 62.1±7.5 to 80.0±18.5 (P=0.002), respectively. While significant improvement was observed in all patient reported outcome measures tested, 19 (40.4%) hips indicated that "the operation was unsatisfactory." The only factor shown to influence outcomes was preoperative VAS (i.e., worse scores potentially an indicator of poor outcomes). Conclusion: The results of the current study indicate that arthroscopic management may be beneficial for a subset of patients with borderline dysplasia; however, the dissatisfaction rate associated with this treatment approach may be as high as 40%. The poor preoperative pain score appears to be the sole indicator for poor outcomes. SN - 2287-3260 UR - https://www.unboundmedicine.com/medline/citation/31198777/Hip_Arthroscopy_of_a_Painful_Hip_with_Borderline_Dysplasia L2 - https://hipandpelvis.or.kr/DOIx.php?id=10.5371/hp.2019.31.2.102 DB - PRIME DP - Unbound Medicine ER -