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Long-term Outcomes After Arthroscopic Treatment of Femoroacetabular Impingement for Patients With Borderline Dysplasia.
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- Author(s): Selley, Ryan S.; Day, Molly A.; Olsen, Reena; Buza, Stephanie S.; Sink, Ernest L.; Ranawat, Anil S.; Kelly, Bryan T.; Nawabi, Danyal H.
- Source:
American Journal of Sports Medicine. May2023, Vol. 51 Issue 6, p1531-1537. 7p. - Source:
- Additional Information
- Subject Terms: FEMORACETABULAR impingement; HIP surgery; PHYSICAL diagnosis; STRUCTURAL equation modeling; TOTAL hip replacement; CONFIDENCE intervals; ARTHROSCOPY; PREOPERATIVE period; RETROSPECTIVE studies; SURGERY; PATIENTS; CASE-control method; HEALTH outcome assessment; SURGICAL complications; MANN Whitney U Test; FISHER exact test; REGRESSION analysis; TREATMENT effectiveness; CONGENITAL hip dislocation; SEVERITY of illness index; PRE-tests & post-tests; RISK assessment; T-test (Statistics); COMPARATIVE studies; POSTOPERATIVE period; REOPERATION; QUESTIONNAIRES; CHI-squared test; DESCRIPTIVE statistics; DATA analysis software; COMPUTED tomography; LONGITUDINAL method; PROPORTIONAL hazards models; EVALUATION
- Abstract: Background: Outcomes after isolated hip arthroscopic surgery for patients with dysplasia have been unfavorable. Results have included iatrogenic instability and conversion to total hip arthroplasty at a young age. However, patients with borderline dysplasia (BD) have shown more favorable results at short- and medium-term follow-up. Purpose: To assess long-term outcomes after hip arthroscopic surgery for femoroacetabular impingement in patients with BD (lateral center-edge angle [LCEA] = 18°-25°) compared with a control group of patients without dysplasia (LCEA = 26°-40°). Study Design: Cohort study; Level of evidence, 3. Methods: We identified a group of 33 patients (38 hips) with BD who were treated for FAI between March 2009 and July 2012. An age- and sex-matched control group of 83 patients (96 hips) was also identified. Patient-reported outcome scores were collected preoperatively and subsequently at a mean of 9.6 years postoperatively. Results: The mean LCEA and Tönnis angle were 22.42°± 2.02° and 6.27°± 3.23° in the BD group, respectively, and 31.71°± 3.52° and 2.42°± 3.02° in the control group, respectively (P <.001). At a mean follow-up of 9.6 years (range, 8.2-11.6 years), there was a significant improvement in all patient-reported outcome scores in both groups (P <.001). There were no significant differences between preoperative and postoperative scores or rates of achieving the minimal clinically important difference between the BD and control groups. Bilateral surgery was noted to be a risk factor for any revision during the follow-up period (P <.001). There were 2 hips (5.3%) that underwent revision surgery in the BD group and 10 hips (10.4%) in the control group; of these, 1 patient in the BD group underwent total hip arthroplasty, and 1 patient who had undergone bilateral surgery in the control group underwent bilateral hip resurfacing. Conclusion: Durable outcomes (>9 years) with low revision rates can be expected after hip arthroscopic surgery with an approach that involves labral preservation where possible and careful attention to capsular closure in patients with BD. The observed outcomes were similar to those of a femoroacetabular impingement group with normal coverage. These results highlight the importance of classifying patients into impingement or instability categories and tailoring treatment appropriately with arthroscopic surgery or periacetabular osteotomy, respectively. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of American Journal of Sports Medicine is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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