Hip Arthroscopic Surgery in Borderline Developmental Dysplastic Hips: A Systematic Review

Area of Science:

• Orthopedic Surgery
• Hip Preservation
• Minimally Invasive Procedures

Background:

• The efficacy of hip arthroscopic surgery in patients with borderline developmental dysplastic hip (BDDH) remains a subject of debate.
• BDDH presents unique challenges for surgical intervention due to subtle acetabular dysplasia.

Purpose of the Study:

• To systematically review the outcomes of hip arthroscopic surgery in patients diagnosed with BDDH.
• To identify factors that may influence the success of these procedures.

Main Methods:

• A systematic review of studies published up to March 2018 was conducted using PubMed, Embase, and Cochrane Library.
• Included studies focused on primary hip arthroscopic surgery in BDDH patients, assessing patient-reported outcomes and follow-up duration.
• The modified Harris Hip Score (mHHS) was the primary outcome measure, with failure rates and other PROMs as secondary outcomes.

Main Results:

• Nine studies involving 425 patients demonstrated significant improvements in mHHS (61.8 to 82.8) and most other patient-reported outcomes.
• The overall failure rate was 14.1%, with a 8.5% reoperation rate and a 4.4%-26.0% conversion rate to total hip arthroplasty.
• Factors such as cartilage damage, osteoarthritis, ligamentum teres tears, and femoroacetabular impingement were found to impact surgical outcomes.

Conclusions:

• Hip arthroscopic surgery appears to be a viable option for BDDH, offering potential functional improvements.
• However, outcomes are influenced by several risk factors, highlighting the need for careful patient selection.
• Higher levels of evidence are required to definitively support these findings and guide clinical practice.