Endoscopic shelf acetabuloplasty can improve clinical outcomes and achieve return to sports-related activity in active patients with hip dysplasia

Knee Surg Sports Traumatol Arthrosc. 2018 Oct;26(10):3165-3177. doi: 10.1007/s00167-017-4787-0. Epub 2017 Nov 28.

Abstract

Purpose: To investigate clinical outcomes and return to sports-related activity following endoscopic shelf acetabuloplasty combined with labral repair in the treatment of the active patients with developmental dysplasia of the hip (DDH).

Methods: Between 2011 and 2013, 32 patients (36 hips; 11 males and 21 females; 11 right 17 left 4 bilateral; median age 28.5, range 12-51 years), who underwent endoscopic shelf acetabuloplasty combined with labral repair and met the inclusion criteria were enrolled in this study. There was a minimum follow-up of 2 years (average 32.3 ± 3 months, range 24-48 months). Patient-reported outcome (PRO) scores including the modified Harris Hip Score (MHHS) and Non-Arthritis Hip Score (NAHS) were obtained preoperatively and at final follow-up for the assessment of surgical outcomes.

Results: The mean MHHS significantly improved from 68.4 ± 14.3 (range 23.1-95.7) preoperatively to 94.5 ± 8.5 (range 66-100) at final follow-up (p = 0.001). Similarly, the NAHS also significantly improved from 51.3 ± 11.9 (range 23-76) preoperatively to 73.0 ± 7.4 (range 44-80) at final follow-up (p = 0.001). The mean LCE angle significantly increased postoperatively but partially decreased at final follow-up (mean preoperative versus postoperative versus final follow-up: 16.0 range 5-24, versus 40.1 range 27-58, versus 30.1 range 20-41. p = 0.001, respectively). There were 3 patients who returned to a higher activity level, 20 patients who returned to the same activity level, and 6 patients who returned to a lower activity level. The mean period from surgery to return to play was 9.0 ± 3.5 months (range 5-18).

Conclusion: Endoscopic shelf acetabuloplasty provides promising clinical outcomes and return to sports-related activity for active patients with DDH.

Level of evidence: Level IV.

Keywords: Acetabular labral tear; Developmental dysplasia of the hip; Hip arthroscopy; Return to sport; Shelf acetabuloplasty.

MeSH terms

  • Acetabuloplasty*
  • Activities of Daily Living
  • Adolescent
  • Adult
  • Arthroscopy
  • Child
  • Endoscopy*
  • Female
  • Follow-Up Studies
  • Hip / surgery
  • Hip Dislocation, Congenital / surgery*
  • Hip Joint / physiopathology
  • Hip Joint / surgery
  • Humans
  • Male
  • Middle Aged
  • Patient Reported Outcome Measures
  • Postoperative Period
  • Retrospective Studies
  • Return to Sport*
  • Treatment Outcome
  • Young Adult