Summary
Arthroscopic Labral repair for developmental dysplasia of the hip
Data
Background
Recent studies revealed that hip arthroscopic debridement of labrum could not be useful treatment for the patients with developmental dysplasia of the hip (DDH) since acetabular labrum is prerequisite for hip joint stabilization. There is a paucity of literature concerning arthroscopic labral repair and osteochondroplasty for patients with DDH. The purpose of this study was to evaluate the early clinical outcome following hip arthroscopy for DDH in hip joint.
Subjects and Method
Between 3/2009 and 6/2010, 21 patients with DDH who underwent arthroscopy by single surgeon are enrolled in this study. One cases with bilateral and four cases associated with osteoarthritis were excluded. Gender 4 males and 12 females Average Age 25.1+−11 (range;12∼45). In 12 of 16 patients, the onsets of pain were associated with sports activity.
At hip arthroscopy, 12 of 16 patients underwent labral repair and bump osteotomy for DDH combined with cam type impingement. Four patient underwent labral repair without osteochondroplasty. Average follow-up was obtained clinically and radiographically on 100% at minimum one year (average; 14 months range; 12∼ 19).
Results
Modified Harris hip score (MHHS) significantly improved from 57+−20.4 (range;12∼81.4) to 89.4+−20.5 (range; 18.7∼100). The overall evaluation was excellent in thirteen patients, but initial arthroscopy failed in three patients. Thirteen of the sixteen patients were free from hip pain, two had mild pain occasionally and one had severe pain consistently. In these three patients, Central-Edge (CE) angle are less than 15 degree and classification of cartilage delamination (MAHORN) are over grade III. One of three patients underwent second arthroscopy. We observed advanced arthritis in 2 patients and lateral migration in one patient.
Discussion and Conclusions
These clinical outcomes suggest that arthroscopic labral repair and cam osteochondroplasty provide satisfactory outcome in overall patients but fair or poor results in the patients with CE angle less than 15 degree as well as severe cartilage delamination at the time of surgery. Assessing patients prudently for the presence of DDH is still important prior to hip arthroscopy. Further investigation should be necessary to develop arthroscopic stragegy in the assessment and management of patients with DDH.
Article info
Identification
Copyright
© 2012 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
