PMID- 32577106
OWN - NLM
STAT- MEDLINE
DCOM- 20200819
LR  - 20200819
IS  - 1555-1377 (Electronic)
IS  - 1541-5457 (Print)
IS  - 1541-5457 (Linking)
VI  - 39
IP  - 2
DP  - 2019
TI  - Outcomes of Surgical Management of Borderline Hip Dysplasia: A Systematic Review.
PG  - 40-48
AB  - BACKGROUND: Multiple reports have detailed clinical outcomes in surgically 
      treated patients with borderline hip dysplasia. The purpose of this systematic 
      review was to define patient outcomes following these surgical interventions. 
      METHODS: Searches were developed using an iterative process of gathering and 
      evaluating terms. Comprehensive strategies including both index and keyword 
      methods were devised for the following databases: PubMed, Embase, and Cochrane 
      CENTRAL. Independent review and data abstraction was performed by two authors. 
      Inclusion criteria were clear delineation of outcomes for patients with 
      borderline hip dysplasia (Lateral center edge angle (LCEA) 18-25 degrees ) and outcomes 
      following hip arthroscopy and/ or periacetabular osteotomy (PAO), including 
      patient reported outcomes (PROs), revision arthroscopy, and conversion to Total 
      Hip Arthroplasty. Exclusion criteria included alternative surgical procedures 
      including "shelf" or "salvage" osteotomies, studies without patient outcomes or 
      clearly delineated results for patients with borderline dysplasia, inclusion of 
      <5 borderline patients, or inadequate follow-up defined as < 12 months. RESULTS: 
      Thirteen of 2109 articles met inclusion criteria for full data analysis. 505 
      patients (mean age 29.6 years, 67.7% female) with borderline dysplasia (mean LCEA 
      22.3 degrees ) were treated with hip arthroscopy. The majority of studies reported 
      outcomes using the modified Harris Hip Score (mHHS) and Hip Outcome Score Sports 
      Specific Subscale (HOS-SSS); all showed post-operative improvement with mean 
      increase of 21.0 and 26.8 points, respectively. Revision arthroscopy rate was 
      7.5% (31/412), and a total hip arthroplasty conversion rate was 4.0% (18/455). 
      The average combined total reoperation rate was 13.7% (69/505). CONCLUSION: 
      Arthroscopic management of borderline hip dysplasia is associated with meaningful 
      improvement in PRO scores. However, there appears to be a high reoperation rate 
      including both arthroscopic and open revision procedures. There is a paucity of 
      studies reporting outcomes of PAO in patients with borderline hip dysplasia.Level 
      of evidence: Systematic review of Level III and Level IV studies.
CI  - Copyright (c) The Iowa Orthopaedic Journal 2019.
FAU - Barton, Cameron
AU  - Barton C
AD  - Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, 
      IA USA.
FAU - Scott, Elizabeth
AU  - Scott E
AD  - Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, 
      IA USA.
FAU - Khazi, Zain M
AU  - Khazi ZM
AD  - Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, 
      IA USA.
FAU - Willey, Michael
AU  - Willey M
AD  - Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, 
      IA USA.
FAU - Westermann, Robert
AU  - Westermann R
AD  - Department of Orthopedics and Rehabilitation, The University of Iowa, Iowa City, 
      IA USA.
LA  - eng
PT  - Journal Article
PT  - Systematic Review
PL  - United States
TA  - Iowa Orthop J
JT  - The Iowa orthopaedic journal
JID - 8908272
SB  - IM
MH  - Arthroplasty, Replacement, Hip/statistics & numerical data
MH  - *Arthroscopy
MH  - Disability Evaluation
MH  - Hip Dislocation/*surgery
MH  - Humans
MH  - *Osteotomy
MH  - *Patient Reported Outcome Measures
MH  - Reoperation/statistics & numerical data
PMC - PMC7047291
OTO - NOTNLM
OT  - borderline hip dysplasia
OT  - hip arthroscopy
OT  - outcomes
COIS- Disclosures: The authors report no potential conflicts of interest related to 
      this study.
EDAT- 2019/01/01 00:00
MHDA- 2020/08/20 06:00
PMCR- 2019/01/01
CRDT- 2020/06/25 06:00
PHST- 2020/06/25 06:00 [entrez]
PHST- 2019/01/01 00:00 [pubmed]
PHST- 2020/08/20 06:00 [medline]
PHST- 2019/01/01 00:00 [pmc-release]
PST - ppublish
SO  - Iowa Orthop J. 2019;39(2):40-48.