Study cites factors of success, failure for hips with dysplasia vs FAI after arthroscopy

Recently published data indicated that after arthroscopic management, dysplastic hips had inferior good/excellent results with higher rates of failure than hips with femoroacetabular impingement.

Researchers retrospectively reviewed the records of 77 patients who underwent an all-arthroscopic approach for treatment of dysplastic hip deformities. Investigators also analyzed 215 age-matched patients who were treated arthroscopically for femoroacetabular impingement (FAI) without hip dysplasia. Mean follow-up for the dysplastic hips was 26 months after arthroscopy vs. 22.7 months for the FAI group. Investigators evaluated patients using a modified Harris Hip score (mHHS), SF-36 and VAS for pain. They also recorded revision surgeries and complications.

Results showed the mean lateral center-edge angle was 20.8°. Investigators also found a mean Tönnis angle of 11°. The mHHS improved from 65 preoperatively to 81.3 at final follow-up in the dysplastic cohort. In the FAI group, these values improved from 24.4 to 88.4, respectively. Investigators noted good/excellent results in 60.9% of the dysplastic hips. Using a mHHS of at least 70, osteotomy or hip arthroplasty to define failure, investigators found a failure rate of 32.2% for that group. In comparison, researchers found 81.2% of the FAI hips had good/excellent results and 10.5% failed during the final follow-up.

In the dysplastic hips, lower scores correlated with Grade 4 chondral defects and patients who had capsular plication and labral repair had better results and lower failure rates. At the follow-up, microfracture approached significance for lower mHHS in both groups. No iatrogenic subluxations or dislocations were reported during the follow-up. ‒ by Monica Jaramillo

Disclosures: Larson is a consultant for A3 Surgical and Smith & Nephew, and also has stock options in A3 Surgical. Please see the full study for a list of all other authors’ relevant financial disclosures.

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Source:

Larson CM, et al. Am J Sports Med. 2016;doi:10.1177/0363546515613068.