Purpose
To evaluate midterm outcomes, long-term outcomes, and survivorship in the borderline
dysplastic population after primary hip arthroscopy.
Methods
A systematic review of current literature was performed with the following key words:
“hip, “arthroscopy,” “borderline dysplasia,” “borderline hip dysplasia,” “developmental
dysplasia,” “ten-year,” “survivorship,” “10-year,” “5-year,” “five year,” “mid-term,”
“long-term,” “outcomes,” “arthroscopic,” and “femoroacetabular impingement” in PubMed,
Cochrane, and Scopus in March 2022 using the Preferred Reporting Items for Systematic
Reviews and Meta-analyses guidelines. The following information was recorded: title,
author, publication date, study design, demographic, number of hips, follow-up time,
study period, indications for hip arthroscopy, patient-reported outcomes (PROs), characteristics
of patients converting to total hip arthroplasty (THA), and rates of secondary surgeries
and conversion to THA were recorded. Survivorship was defined as not converting to
THA. Kappa values for the title/abstract and full-text screening were calculated.
Forest plots were created for PROs that were included in 3 or more studies.
Results
Six articles comprising 413 hips were included in the study. Three studies were Level
III evidence, and 3 studies were Level IV evidence. Average follow-up ranged from
5.7 to 12.2 years. One study defined borderline hip dysplasia as lateral center-edge
angle 18-25° and 5 defined it as lateral center-edge angle 20-25°. All studies included
PROs and reported significant improvement after surgery in at least one PRO. Three
studies reported clinical benefit and across the studies at least 70% of patients
achieved minimum clinically important difference in at least one PRO. Rates of undergoing
revision hip arthroscopy and THA ranged from 2.1% to 7% and 0% to 24%, respectively.
Tönnis grade 2, Tönnis angle >15, and Outerbridge Grade IV cartilage damage were identified
as predictors of conversion to THA.
Conclusions
Patients with borderline hip dysplasia undergoing primary hip arthroscopy demonstrated
significant improvement in PROs at midterm and long-term follow-up. Survivorship at
midterm follow-up was 98.2% (328/334 hips) and 76.3% (29/38 hips) at long-term follow-up.
Level of Evidence
Level IV, systematic review of Level III and Level IV studies.
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Article info
Publication history
Published online: December 31, 2022
Accepted:
December 22,
2022
Received:
July 23,
2022
Publication stage
In Press Journal Pre-ProofFootnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
This study was performed at the Department of Orthopaedics and Rehabilitation, Yale School of Medicine.
Identification
Copyright
© 2022 by the Arthroscopy Association of North America
