Abstract
Objectives:
To compare minimum 2-year patient-reported outcomes and achievement of clinically significant outcomes in flexibles athletes with and without borderline hip dysplasia (BHD) undergoing primary hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with capsular plication.
Methods:
Data was prospectively collected for patients undergoing primary hip arthroscopy for FAIS with borderline hip dysplasia (BHD), defined as a lateral center edge angle (LCEA) of 18° to 25°, with primary participation in a sport with high flexibility requirement including dance, gymnastics, figure skating, yoga, cheerleading, and martial arts. These patients were matched 1:2 to flexible athletes with an LCEA >25° controlling for age, sex, body mass index (BMI) and follow up duration. Preoperative and minimum 2-year postoperative patient-reported outcomes included: Hip Outcome Score (HOS) Activities of Daily Living, HOS Sports Scale, International Hip Outcome Score 12, modified Harris Hip Score, and Visual Analog Scale for Pain. Cohort-specific Minimal Clinically Important Difference (MCID) and Patient Acceptable Symptom State (PASS) were calculated and compared between groups.
Results:
Fifty-two flexible athletes with BHD were matched to 104 flexible athletes without BHD. Similar sport participation (45% dance vs. 41%, p=0.874) and level of competition (74% vs. 74% recreational, p=0.877) were observed. Preoperative LCEA (22.2° ± 1.6 vs. 31.5° ± 3.9, p < 0.001) and Tönnis angle (10.9 °± 3.7 vs. 5.8° ± 4.4, p < 0.001) differed significantly between groups. Capsular plication was performed in all cases (100% and 100%, p = 1.000). Both groups achieved significant improvement in all PROs (p ≤ 0.001) with no differences in PROs between groups (p ≥ 0.147). High MCID (95.7%, 94.8%) and PASS (71.7%, 72.2%) achievement for any PRO was observed with no differences between groups (p ≥ 0.222).
Conclusions:
Flexible athletes with BHD achieve successful and similar outcomes to those without BHD after primary hip arthroscopy for FAIS with capsular plication.
