PMID- 37641583 OWN - NLM STAT- Publisher LR - 20231006 IS - 1757-7861 (Electronic) IS - 1757-7853 (Print) IS - 1757-7853 (Linking) VI - 15 IP - 10 DP - 2023 Oct TI - Lateral Center-edge Angle of 18 degrees (Bone-Edge): Threshold for Hip Arthroscopy Treatment in Patients with Borderline Developmental Dysplasia of the Hip? PG - 2665-2673 LID - 10.1111/os.13877 [doi] AB - OBJECTIVE: Hip arthroscopy for the treatment of symptomatic borderline developmental dysplasia of the hip (BDDH) has been controversial. The purpose of this study was to retrospectively analyze minimum 2-year outcomes of BDDH after arthroscopic surgery and explore the criteria and thresholds of the lateral center-edge angle (LCEA) in arthroscopic surgery for BDDH. METHODS: Data were retrospectively collected from patients aged 18-50 who underwent arthroscopic surgery for BDDH and had an LCEA 18-25 degrees between September 2016 and June 2020. The consistency of interobserver and intraobserver measurements of bone-edge LCEA was analyzed. Patients were divided into two groups based on LCEA (18-20 degrees and 20-25 degrees ) and the results of arthroscopy compared between groups. Patient-reported outcome (PRO) scores, consisting of the modified Harris hip score (mHHS), the visual analogue scale (VAS) and the international hip outcome tool-12 (IHOT-12), the minimal clinically important difference (MCID) and patient acceptable symptom status (PASS) were calculated. RESULTS: In 52 patients with >/=2-year follow-up, female patients accounted for 71.2% and the mean age was 30.8 +/- 8.4 years (range: 18 to 49 years). There was a high level of agreement when measuring the bone-edge LCEA definition of BDDH (Kappa = 0.921). Interobserver repeatability (ICC = 0.909, 95%CI: 0.847-0.947) and intraobserver repeatability (ICC = 0.944, 95%CI: 0.905-0.968) were excellent for bone-edge LCEA measurements. In addition to LCEA and Tonnis angle, there were no significant differences in alpha angle, neck stem angle, femoral anteversion angle, medial joint space, Tonnis grade of osteoarthritis, acetabular retroversion (8 sign), Cam deformity and anterior inferior iliac spine (AIIS) morphology between the two groups (p > 0.05). Intraoperative findings and procedures showed no statistical difference between groups (p > 0.05). The mean follow-up time was 44.4 +/- 11.0 months (range: 25 to 64 months). Postoperative VAS, mHHS and IHOT-12 scores in the LCEA 18-20 degrees group and the LCEA 20-25 degrees group were significantly improved compared with those before surgery, and there was no statistically significant difference in the percentage of MCID and PASS (mHHS and iHOT-12) between the groups (p > 0.05). CONCLUSION: Patients in the LCEA 18-20 degrees group and the LCEA 20-25 degrees group achieved favorable outcomes after arthroscopic surgery. LCEA 18 degrees (bone-edge) should be the threshold for hip arthroscopic surgery in BDDH patients without obvious hip instability. CI - (c) 2023 The Authors. Orthopaedic Surgery published by Tianjin Hospital and John Wiley & Sons Australia, Ltd. FAU - Zhang, Jia AU - Zhang J AUID- ORCID: 0000-0003-1953-6561 AD - Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China. AD - Medical School of Chinese PLA, Beijing, China. FAU - Li, Chunbao AU - Li C AUID- ORCID: 0000-0002-6513-8946 AD - Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China. FAU - Zhang, Jianping AU - Zhang J AUID- ORCID: 0000-0003-3045-6685 AD - Department of Orthopedics, 920 Hospital of Joint Logistics Support Force, Kunming, China. FAU - Zhao, Gang AU - Zhao G AUID- ORCID: 0000-0002-5181-9599 AD - Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China. AD - Medical School of Chinese PLA, Beijing, China. FAU - Liu, Yujie AU - Liu Y AUID- ORCID: 0000-0001-5949-9545 AD - Department of Orthopedics, the Fourth Medical Center of Chinese PLA General Hospital, Beijing, China. LA - eng GR - 82072517/National Natural Science Foundation of China/ PT - Journal Article DEP - 20230829 PL - Australia TA - Orthop Surg JT - Orthopaedic surgery JID - 101501666 SB - IM PMC - PMC10549843 OTO - NOTNLM OT - Arthroscopy OT - Borderline developmental dysplasia of the hip OT - Lateral center-edge angle COIS- The authors have declared that there are no competing interests. EDAT- 2023/08/29 06:42 MHDA- 2023/08/29 06:42 PMCR- 2023/08/29 CRDT- 2023/08/29 03:35 PHST- 2023/08/03 00:00 [revised] PHST- 2023/06/13 00:00 [received] PHST- 2023/08/07 00:00 [accepted] PHST- 2023/08/29 06:42 [pubmed] PHST- 2023/08/29 06:42 [medline] PHST- 2023/08/29 03:35 [entrez] PHST- 2023/08/29 00:00 [pmc-release] AID - OS13877 [pii] AID - 10.1111/os.13877 [doi] PST - ppublish SO - Orthop Surg. 2023 Oct;15(10):2665-2673. doi: 10.1111/os.13877. Epub 2023 Aug 29.