Concomitant Peri-Acetabular Osteotomy and Arthroscopy Versus Isolated Arthroscopy With Capsular Plication for
Roger Quesada-Jimenez1, Andrew R Schab1, Meredith F Cohen1
1American Hip Institute Research Foundation, Chicago, Illinois, U.S.A.
Purpose:
To compare minimum 2-year outcomes of periacetabular osteotomy (PAO) with concomitant hip arthroscopy (HA) versus isolated HA with capsular plication in patients with borderline hip dysplasia (BHD).
Methods:
Data were retrospectively reviewed for patients who underwent surgery for femoroacetabular impingement in the setting of BHD between September 2008 and December 2021. Included patients had preoperative and minimum 2-year patient-reported outcome (PRO) scores. Patients who underwent staged PAO and HA comprised the PAO group. Patients who underwent isolated HA with capsular plication comprised the HA group. Matching occurred at a 1:1 ratio based on age, sex, body mass index, and Tönnis grade.
Results:
A total of 74 hips were included. In the HA group, the mean postoperative modified Harris Hip Score, Nonarthritic Hip Score, Hip Outcome Score-Sports Specific Subscale, and visual analog scale score were 90.32 ± 12.39, 89.46 ± 11.57, 81.47 ± 20.54, and 1.74 ± 1.89, respectively. In the PAO group, these PRO values were 90.69 ± 13.46, 91.59 ± 10.80, 82.20 ± 21.23, and 1.49 ± 1.94, respectively. The HA group met the minimal clinically important difference for the modified Harris Hip Score (89.19%), Nonarthritic Hip Score (86.49%), and Hip Outcome Score-Sports Specific Subscale (72.97%) at similar rates to the PAO group (89.19%, 86.49%, and 78.38%, respectively). The rates of achieving the patient acceptable symptom state for these PROs were 86.49%, 72.97%, and 67.57%, respectively, in the HA group and 86.49%, 78.38%, and 70.27%, respectively, in the PAO group. The rates of achieving maximal outcome improvement for these PROs were 81.1%, 75.68%, and 70.27%, respectively, in the HA group and 75.68%, 75.68%, and 70.27%, respectively, in the PAO group. Complications occurred in 10.81% of patients in the PAO group and 5.41% of those in the HA group (P = .67).
Conclusions:
PAO with concomitant HA and isolated HA with capsular plication in the setting of BHD yielded favorable and comparable outcomes. A high percentage of patients in both the HA and PAO groups reached clinically relevant thresholds, with similar rates of revision and conversion to arthroplasty at minimum 2-year follow-up.
Level Of Evidence:
Level III, retrospective comparative study.
