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Hip arthroscopy in the setting of hip dysplasia: A systematic review
M Yeung1, M Kowalczuk1, N Simunovic2
1McMaster University, 1200 Main St W, Room 4E15, Hamilton, Ontario L8N 3Z5, Canada.
Insights
Hip arthroscopy in hip dysplasia shows improved outcomes but carries high revision rates. Milder dysplasia cases may have acceptable results, but definitions vary significantly across studies.
Area of Science:
- Orthopaedic Surgery
- Sports Medicine
- Hip Preservation
Background:
- Hip arthroscopy is increasingly performed for hip pain.
- Its efficacy in hip dysplasia remains debated due to variable outcomes.
- Defining and diagnosing hip dysplasia consistently is challenging.
Purpose of the Study:
- To systematically review the outcomes of hip arthroscopy in patients with hip dysplasia.
- To evaluate the impact of dysplasia severity on surgical outcomes.
- To assess revision and conversion to total hip arthroplasty rates.
Main Methods:
- Systematic literature search up to July 2015.
- Inclusion of studies on hip arthroscopy for hip dysplasia.
- Data extraction on study parameters, outcomes, and re-operation rates.
Main Results:
- 18 studies with 889 patients were included.
- Most studies used the centre edge angle to define dysplasia, with variable ranges.
- 89% of studies reported improved post-operative scores, but revision rates were 14.1% and conversion to total hip arthroplasty was 9.6%.
Conclusions:
- Hip arthroscopy in hip dysplasia yields improved outcomes but has significant re-operation and conversion rates.
- The definition and diagnosis of hip dysplasia vary widely in the literature.
- Outcomes may be more favorable in milder or borderline hip dysplasia cases, though further research is needed.
Objective:
Hip arthroscopy in the setting of hip dysplasia is controversial in the orthopaedic community, as the outcome literature has been variable and inconclusive. We hypothesise that outcomes of hip arthroscopy may be diminished in the setting of hip dysplasia, but outcomes may be acceptable in milder or borderline cases of hip dysplasia.
Methods:
A systematic search was performed in duplicate for studies investigating the outcome of hip arthroscopy in the setting of hip dysplasia up to July 2015. Study parameters including sample size, definition of dysplasia, outcomes measures, and re-operation rates were obtained. Furthermore, the levels of evidence of studies were collected and quality assessment was performed.
Results:
The systematic review identified 18 studies investigating hip arthroscopy in the setting of hip dysplasia, with 889 included patients. Criteria used by the studies to diagnose hip dysplasia and borderline hip dysplasia included centre edge angle in 72% of studies but the range of angles were quite variable. Although 89% of studies reported improved post-operative outcome scores in the setting of hip dysplasia, revision rates were considerable (14.1%), with 9.6% requiring conversion to total hip arthroplasty.
Conclusion:
The available orthopaedic literature suggests that although improved outcomes are seen in hip arthroscopy in the setting of hip dysplasia, there is a high rate of re-operation and conversion to total hip arthroplasty. Furthermore, the criteria used to define hip dysplasia vary considerably among published studies.Cite this article: M. Yeung, M. Kowalczuk, N. Simunovic, O. R. Ayeni. Hip arthroscopy in the setting of hip dysplasia: A systematic review. Bone Joint Res 2016;5:225-231. DOI: 10.1302/2046-3758.56.2000533.
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