PMID- 32548181
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220415
IS  - 2325-9671 (Print)
IS  - 2325-9671 (Electronic)
IS  - 2325-9671 (Linking)
VI  - 8
IP  - 5
DP  - 2020 May
TI  - Is Hip Arthroscopy an Adequate Therapy for the Borderline Dysplastic Hip? 
      Correlation Between Radiologic Findings and Clinical Outcomes.
PG  - 2325967120920851
LID - 10.1177/2325967120920851 [doi]
LID - 2325967120920851
AB  - BACKGROUND: Recent studies have shown that assessment of the lateral center-edge 
      angle (LCEA) between 18 degrees  and 25 degrees  is not sufficient to adequately classify mildly 
      dysplastic hips and that further radiological features should be considered. 
      However, no correlation between different morphologic features and clinical 
      outcomes has been investigated so far. PURPOSE: To analyze the clinical outcomes 
      of patients with different subtypes of borderline dysplastic hips who underwent 
      arthroscopic surgery. STUDY DESIGN: Cohort study; Level of evidence, 3. METHODS: 
      We examined patients with an LCEA between 18 degrees  and 25 degrees  who underwent arthroscopic 
      treatment for femoroacetabular impingement syndrome between January 2015 and 
      December 2016. A hierarchical cluster analysis was performed to identify hip 
      morphologic subtypes according to radiographic parameters, including the LCEA, 
      femoro-epiphyseal acetabular roof (FEAR) index, anterior and posterior wall 
      indices (AWI and PWI), Tonnis angle, alpha angle, and femoral neck-shaft angle. 
      In addition, the International Hip Outcome Tool 12 (iHOT-12) and a visual analog 
      scale (VAS) for pain were applied preoperatively and at follow-up, and the 
      results were compared among the different clusters. Previously reported minimal 
      clinically important difference (MCID) and patient acceptable symptomatic state 
      (PASS) values were used to determine clinically significant improvements. 
      RESULTS: A total of 40 patients were identified. Of these, 36 patients were 
      available for evaluation at a mean follow-up of 43.8 months. In total, 4 
      sex-independent clusters with different morphologic patterns of the hip were 
      identified: cluster 1, unstable anterolateral deficiency (FEAR index >2 degrees , AWI 
      <0.35); cluster 2, stable anterolateral deficiency (FEAR index <2 degrees , AWI <0.35); 
      cluster 3, stable lateral deficiency (FEAR index >2 degrees , normal AWI and PWI); and 
      cluster 4, stable posterolateral deficiency (FEAR index <2 degrees , PWI <0.85). At 
      follow-up, clusters 1, 2, and 3 showed significantly improved iHOT-12 (P < .0001) 
      and VAS pain (P < .0001) scores, and cluster 4 showed no significant 
      improvements. The MCID of 15.2 points was achieved by all patients in clusters 2 
      and 3, by 63% of patients in cluster 1, and by 23% of patients in cluster 4. 
      Clusters 2 and 3 differed significantly from clusters 1 and 4 (P = .02). A 
      postoperative PASS score of 60 was achieved by all patients in cluster 3, by 86% 
      of patients in cluster 2, by 63% of patients in cluster 1, and by 20% of patients 
      in cluster 4. The differences between the groups were statistically significant 
      (P = .01). CONCLUSION: Arthroscopic surgery yielded good results in the treatment 
      of stable borderline hip dysplasia with anterolateral and lateral deficiency. In 
      contrast, borderline hip dysplasia with acetabular retroversion showed no 
      improvements after arthroscopic therapy. This study underlines the need for an 
      accurate analysis of all possible radiological signs to adequately classify 
      borderline dysplastic hips.
CI  - (c) The Author(s) 2020.
FAU - Zimmerer, Alexander
AU  - Zimmerer A
AD  - ARCUS Sportklinik, Pforzheim, Germany.
AD  - University of Greifswald, Greifswald, Germany.
FAU - Schneider, Marco M
AU  - Schneider MM
AD  - ARCUS Sportklinik, Pforzheim, Germany.
AD  - University of Witten/Herdecke, Witten, Germany.
FAU - Nietschke, Rainer
AU  - Nietschke R
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Miehlke, Wolfgang
AU  - Miehlke W
AD  - ARCUS Sportklinik, Pforzheim, Germany.
FAU - Sobau, Christian
AU  - Sobau C
AD  - ARCUS Sportklinik, Pforzheim, Germany.
LA  - eng
PT  - Journal Article
DEP - 20200520
PL  - United States
TA  - Orthop J Sports Med
JT  - Orthopaedic journal of sports medicine
JID - 101620522
EIN - Orthop J Sports Med. 2020 Sep 30;8(9):2325967120966101. PMID: 33088842
PMC - PMC7249583
OTO - NOTNLM
OT  - acetabular borderline dysplasia
OT  - borderline hip dysplasia
OT  - hip classification
OT  - hip pain
OT  - patient-related outcome
OT  - periacetabular osteotomy
COIS- One or more of the authors has declared the following potential conflict of 
      interest or source of funding: W.M. has received consulting fees from Arthrex and 
      Richard Wolf. AOSSM checks author disclosures against the Open Payments Database 
      (OPD). AOSSM has not conducted an independent investigation on the OPD and 
      disclaims any liability or responsibility relating thereto.
EDAT- 2020/06/18 06:00
MHDA- 2020/06/18 06:01
PMCR- 2020/05/20
CRDT- 2020/06/18 06:00
PHST- 2020/01/23 00:00 [received]
PHST- 2020/02/10 00:00 [accepted]
PHST- 2020/06/18 06:00 [entrez]
PHST- 2020/06/18 06:00 [pubmed]
PHST- 2020/06/18 06:01 [medline]
PHST- 2020/05/20 00:00 [pmc-release]
AID - 10.1177_2325967120920851 [pii]
AID - 10.1177/2325967120920851 [doi]
PST - epublish
SO  - Orthop J Sports Med. 2020 May 20;8(5):2325967120920851. doi: 
      10.1177/2325967120920851. eCollection 2020 May.