PMID- 33216619
OWN - NLM
STAT- MEDLINE
DCOM- 20210215
LR  - 20210215
IS  - 1552-3365 (Electronic)
IS  - 0363-5465 (Linking)
VI  - 49
IP  - 1
DP  - 2021 Jan
TI  - Revision Hip Arthroscopy in the Borderline Dysplastic Population: Reporting 
      Outcomes With Minimum 2-Year Follow-up, With a Subanalysis Against a 
      Propensity-Matched Nondysplastic Control Group.
PG  - 66-75
LID - 10.1177/0363546520969878 [doi]
AB  - BACKGROUND: Hip arthroscopy in patients with borderline dysplasia continues to be 
      surrounded by controversy. Even more controversial is the management of the 
      failed hip arthroscopy in this population. There is a paucity of studies in 
      contemporary literature regarding outcomes after arthroscopic revision surgery. 
      PURPOSE: (1) To report minimum 2-year patient-reported outcome (PRO) scores in 
      patients with borderline dysplasia who underwent revision hip arthroscopy and (2) 
      to compare these PRO scores with those of a propensity-matched control group 
      without dysplasia who underwent revision hip arthroscopy. STUDY DESIGN: Cohort 
      study; Level of evidence, 3. METHODS: Data were prospectively collected between 
      August 2009 and November 2017. Inclusion criteria were revision arthroscopic 
      surgery, capsular plication, and baseline and minimum 2-year follow-up for the 
      following PROs: modified Harris Hip Score (mHHS), Nonarthritic Hip Score (NAHS), 
      Hip Outcome Score-Sports Specific Subscale (HOS-SSS), and visual analog scale 
      (VAS) for pain. Patients with Tonnis grade >1 or previous hip conditions were 
      excluded. Two groups were created: a study group with borderline dysplasia 
      (lateral center-edge angle [LCEA], 18 degrees -25 degrees ) and a control group without dysplasia 
      (LCEA, 25 degrees -40 degrees ). Groups were propensity-matched in a 1:3 ratio for sex, age, body 
      mass index, and follow-up time. RESULTS: A total of 22 revision borderline 
      dysplastic hips (21 patients) had a minimum 2-year follow-up during the study 
      period. Patients in this group reported significant improvements for all PROs 
      from baseline and achieved the minimal clinically important difference (MCID) for 
      the mHHS at a rate of 70%. Moreover, 21 borderline dysplastic hips (21 patients) 
      were matched to 63 control hips (63 patients). Mean LCEA for the study and 
      control groups was 22.6 +/- 1.7 and 32.0 +/- 5.0, respectively. Both groups reported 
      similar improvement in all PROs. The rate for achieving the MCID for the mHHS and 
      VAS was similar between groups; however, the control group had higher rates of 
      meeting the MCID for the HOS-SSS and NAHS (P = .042 and P = .025, respectively). 
      The rates of conversion to hip arthroplasty were 7.9% (n = 5) in the control 
      group and 23.8% (n = 5) in the borderline dysplasia propensity-matched group (P = 
      .052). The rate of re-revision arthroscopy was 11.1% (n = 7) in the control group 
      and 19.0% (n = 4) on the borderline dysplasia group (P = .350). CONCLUSION: After 
      revision hip arthroscopy, significant improvement was obtained for all PROs in 
      patients with borderline dysplasia at a minimum 2-year follow-up. Moreover, 
      outcomes, patient satisfaction, the rate for achieving the MCID for the mHHS and 
      VAS, and the rate for secondary surgery were similar to those of a 
      propensity-matched control group without dysplasia. Nevertheless, there was a 
      nonsignificant trend toward higher secondary procedures in the study group; 
      therefore, arthroscopic revision surgery in the borderline patients should be 
      approached with measured prognosis.
FAU - Maldonado, David R
AU  - Maldonado DR
AD  - Kerlan-Jobe Orthopaedic Institute, Los Angeles, California, USA.
FAU - Kyin, Cynthia
AU  - Kyin C
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
FAU - Shapira, Jacob
AU  - Shapira J
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
FAU - Rosinsky, Philip J
AU  - Rosinsky PJ
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
FAU - Meghpara, Mitchell B
AU  - Meghpara MB
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
AD  - AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
FAU - Yelton, Mitchell J
AU  - Yelton MJ
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
FAU - Lall, Ajay C
AU  - Lall AC
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
AD  - AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
AD  - American Hip Institute, Chicago, Illinois, USA.
FAU - Domb, Benjamin G
AU  - Domb BG
AD  - American Hip Institute Research Foundation, Chicago, Illinois, USA.
AD  - AMITA Health St Alexius Medical Center, Hoffman Estates, Illinois, USA.
AD  - American Hip Institute, Chicago, Illinois, USA.
LA  - eng
PT  - Journal Article
DEP - 20201120
PL  - United States
TA  - Am J Sports Med
JT  - The American journal of sports medicine
JID - 7609541
SB  - IM
MH  - Adult
MH  - Arthroscopy/adverse effects/*methods
MH  - Cohort Studies
MH  - Control Groups
MH  - Female
MH  - Femoracetabular Impingement/*surgery
MH  - Follow-Up Studies
MH  - *Hip Dislocation
MH  - Hip Joint/*surgery
MH  - Humans
MH  - Male
MH  - Patient Reported Outcome Measures
MH  - *Patient Satisfaction
MH  - Propensity Score
MH  - Retrospective Studies
MH  - Treatment Outcome
OTO - NOTNLM
OT  - hip arthroscopy
OT  - hip dysplasia
OT  - outcomes
OT  - revision
EDAT- 2020/11/21 06:00
MHDA- 2021/02/16 06:00
CRDT- 2020/11/20 17:13
PHST- 2020/11/21 06:00 [pubmed]
PHST- 2021/02/16 06:00 [medline]
PHST- 2020/11/20 17:13 [entrez]
AID - 10.1177/0363546520969878 [doi]
PST - ppublish
SO  - Am J Sports Med. 2021 Jan;49(1):66-75. doi: 10.1177/0363546520969878. Epub 2020 
      Nov 20.