Is hip arthroscopy useful in the treatment of borderline dysplasia?: a case-control study.

Autor: Slullitel PA; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. Electronic address: pablo.slullitel@gmail.com., Oñativia JI; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., García-Mansilla A; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Díaz-Dilernia F; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Buttaro MA; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Zanotti G; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Piccaluga F; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina., Comba F; Centro de Cadera, Instituto de Ortopedia Carlos E. Ottolenghi, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina.
Jazyk: English; Spanish; Castilian
Zdroj: Revista espanola de cirugia ortopedica y traumatologia (English ed.) [Rev Esp Cir Ortop Traumatol (Engl Ed)] 2020 Sep - Oct; Vol. 64 (5), pp. 326-334. Date of Electronic Publication: 2020 Aug 10.
DOI: 10.1016/j.recot.2020.04.006
Abstrakt: Introduction: Since arthroscopy remains a controversial treatment of hip dysplasia, our objective was to analyse its clinical and radiological results in a cohort of patients with dysplasia and compare them to controls with femoroacetabular impingement (FAI).
Material and Methods: We retrospectively analysed a series of patients who underwent hip arthroscopy for the treatment of labral pathology; 29 of them with borderline hip dysplasia and 197 with FAI, comparing reoperations and joint survival. The diagnosis of borderline dysplasia was made with a lateral centre-edge angle greater than 18° but less than 25°. The average follow-up was 43 months. We performed a multivariate regression analysis to evaluate the association of reoperations with different demographic, radiological and intraoperative variables.
Results: Seven complications were registered in the FAI group (1 medically treated superficial wound infection, 3 pudendal nerve paraesthesias, 1 deep vein thrombosis and 2 heterotopic ossifications) and none in the dysplasia group. While 5 patients from the FAI group required a new surgery, none of the dysplasia group was re-operated (p=.38). After adjusting for confounders, reoperation showed a very strong association with the finding of osteochondral lesions during index surgery, with a coefficient of .12 (p<.001, 95%CI=.06-.17).
Conclusion: Hip arthroscopy was useful in the treatment of borderline dysplasia, without non-inferior survival compared to the FAI group. We suggest indicating it carefully in dysplasia cases, whenever the symptoms of femoroacetabular friction prevail over those of instability.
(Copyright © 2020 SECOT. Publicado por Elsevier España, S.L.U. All rights reserved.)
Databáze: MEDLINE
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