Outcomes After Labral Repair in Patients With Femoroacetabular Impingement and Borderline Dysplasia

Arthroscopy. 2015 Dec;31(12):2371-9. doi: 10.1016/j.arthro.2015.06.028. Epub 2015 Aug 24.

Abstract

Purpose: To determine outcomes after labral repair in patients with borderline dysplasia and femoroacetabular impingement (FAI).

Methods: Patients with dysplasia treated between June 2005 and March 2009 were identified. The study included only patients aged 18 years or older (mean, 35 years; range, 18 to 69 years) whose affected hip had a Wiberg center-edge angle of 20° to 25° and who underwent primary hip arthroscopy performed by the senior author.

Results: One hundred two hips (100 patients, comprising 50 women and 50 men) underwent hip arthroscopy with labral repair with correction of FAI and capsular closure. Five hips were converted to total hip arthroplasty, and 7 required revision arthroscopy. Of 95 patients (representing 100 hips, 5 of which underwent total hip arthroplasty), 80 were monitored for a minimum of 2 years. At a mean follow-up point of 40 months, the preoperative modified Harris Hip Score had improved from a mean of 63.5 points (range, 20 to 98 points) to a mean of 84.9 points (range, 45 to 100 points) by the latest follow-up (P < .001). The mean score on the Western Ontario and McMaster Universities Arthritis Index improved from 25.3 (range, 0 to 60) to 9.7 (range, 0 to 59) (P < .001). The 12-Item Short Form Health Survey Physical Component Summary score also significantly improved (from 42.5 to 50.9, P = .001), whereas the 12-Item Short Form Health Survey Mental Health Component Summary score showed an insignificant improvement (from 52.4 to 54.1).

Conclusions: This study showed that FAI and labral pathology can be successfully managed using hip arthroscopy, with capsular management, in patients with borderline dysplasia. Patients showed significant improvements in outcomes and high levels of satisfaction after hip arthroscopy. The need for subsequent procedures was similar to that in patients with just FAI and labral repair.

Level of evidence: Level IV, therapeutic case series.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Arthroplasty, Replacement, Hip
  • Arthroscopy*
  • Female
  • Femoracetabular Impingement / complications
  • Femoracetabular Impingement / surgery*
  • Fibrocartilage / surgery*
  • Follow-Up Studies
  • Hip Dislocation / complications
  • Hip Dislocation / surgery*
  • Hip Joint / surgery*
  • Humans
  • Joint Capsule / surgery
  • Male
  • Middle Aged
  • Reoperation
  • Treatment Outcome
  • Young Adult