PMID- 23956133
OWN - NLM
STAT- MEDLINE
DCOM- 20140623
LR  - 20220409
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 41
IP  - 11
DP  - 2013 Nov
TI  - Arthroscopic capsular plication and labral preservation in borderline hip 
      dysplasia: two-year clinical outcomes of a surgical approach to a challenging 
      problem.
PG  - 2591-8
LID - 10.1177/0363546513499154 [doi]
AB  - BACKGROUND: The role of hip arthroscopy in the treatment of patients with 
      dysplasia is unclear because of the spectrum of dysplasia that exists. Patients 
      with borderline dysplasia are generally not candidates for periacetabular 
      osteotomy because of the invasive nature of the procedure. However, arthroscopy 
      in dysplasia has had mixed results and has the potential to exacerbate 
      instability. HYPOTHESIS: Patients with borderline dysplasia will demonstrate 
      postoperative improvement, high satisfaction rates, and low reoperation rates 
      after a surgical approach that includes arthroscopic labral repair augmented by 
      capsular plication with inferior shift. STUDY DESIGN: Case series; Level of 
      evidence, 4. METHODS: Between April 2008 and November 2010, patients less than 40 
      years old who underwent hip arthroscopy for symptomatic intra-articular hip 
      disorders, with a lateral center-edge (CE) angle >/=18 degrees  and </=25 degrees , were included in 
      this study. Patients with Tonnis grade 2 or greater, severe hip dysplasia (CE 
      </=17 degrees ), and Legg-Calve-Perthes disease were excluded. Patient-reported outcome 
      scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score 
      (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Hip Outcome 
      Score-Activity of Daily Living (HOS-ADL), and visual analog scale (VAS) for pain 
      were obtained in all patients preoperatively and at 1, 2, and 3 years 
      postoperatively. Revision surgery and complications were recorded for each group. 
      RESULTS: A total of 26 patients met the criteria to be included in the study. Of 
      these, 22 (85%) patients were available for follow-up. The mean (+/- standard 
      deviation) length of follow-up for this cohort was 27.5 +/- 5.5 months (range, 
      17-39 months) and the average age was 20 years (range, 14-39 years). The mean 
      lateral CE angle was 22.2 degrees  (range, 18 degrees -25 degrees ) and the mean Tonnis angle was 5.8 degrees  
      (range, 0 degrees -17 degrees ). There was significant improvement in all patient-reported 
      outcome scores (mHHS, NAHS, HOS-SSS, and HOS-ADL) (P < .0001). There was a 
      significant improvement in VAS scores from 5.8 to 2.9 (P < .0001). Overall 
      patient satisfaction was 8.4 out of 10. Seventeen patients had good/excellent 
      results (77%). Two patients required revision arthroscopy. CONCLUSION: Patients 
      with borderline dysplasia have often fallen into a gray area between arthroscopy 
      and periacetabular osteotomy, and viable treatment options have remained scarce. 
      The current study demonstrates favorable results at 2-year follow-up for an 
      arthroscopic approach that includes labral repair augmented by capsular plication 
      with inferior shift.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - Benjamin G. Domb, American Hip Institute, 1010 Executive Court, Suite 250, 
      Westmont, IL 60559. DrDomb@americanhipinstitute.org.
FAU - Stake, Christine E
AU  - Stake CE
FAU - Lindner, Dror
AU  - Lindner D
FAU - El-Bitar, Youssef
AU  - El-Bitar Y
FAU - Jackson, Timothy J
AU  - Jackson TJ
LA  - eng
PT  - Journal Article
DEP - 20130816
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Arthroplasty/*methods
MH  - Arthroscopy
MH  - Female
MH  - Follow-Up Studies
MH  - Hip Dislocation/*surgery
MH  - Hip Joint/surgery
MH  - Humans
MH  - Male
MH  - Patient Satisfaction/statistics & numerical data
MH  - Reoperation/statistics & numerical data
MH  - Young Adult
OTO - NOTNLM
OT  - arthroscopy
OT  - capsular plication
OT  - dysplasia
OT  - hip
EDAT- 2013/08/21 06:00
MHDA- 2014/06/24 06:00
CRDT- 2013/08/20 06:00
PHST- 2013/08/20 06:00 [entrez]
PHST- 2013/08/21 06:00 [pubmed]
PHST- 2014/06/24 06:00 [medline]
AID - 0363546513499154 [pii]
AID - 10.1177/0363546513499154 [doi]
PST - ppublish
SO  - Am J Sports Med. 2013 Nov;41(11):2591-8. doi: 10.1177/0363546513499154. Epub 2013 
      Aug 16.