Editorial Commentary: Arthroscopy for Borderline Developmental Dysplasia of the Hip: Selection Determines the Outcomes

Abstract

Although the literature has presented results that favored arthroscopic procedures in treating borderline developmental dysplasia of the hip (BDDH), it remains controversial whether arthroscopic surgery would be better than periacetabular osteotomy for BDDH. Instead of a debate on the application of arthroscopy, the issue worthy of discussion should be distinguishing suitable BDDH candidates for hip arthroscopy. First, identification of patients with real BDDH is critical for making management choices. Second, it should be distinguished whether the major symptoms result from mechanical lesions or functional hip instability. Third, once hip arthroscopy is suggested for BDDH patients, relative contraindications such as advanced age and osteoarthritis should be taken into consideration, in addition to labral repair and capsular closure or plication intraoperatively. In conclusion, more long-term and high-grade evidence is still demanded to end the debate, but we believe that an individualized management strategy based on an accurate diagnosis and comprehensive assessment will bring optimal outcomes for BDDH patients.

Editorial Commentary: Hip Arthroscopy for Femoroacetabular Impingement in Patients With Borderline Dysplasia Does Not Result in Inferior Outcomes Compared With Outcomes in Patients Without Dysplasia: Do Not Fear

“…Obviously, arthroscopy cannot address bony defects and osseous hip instability and PAO will always have a role in addressing these deformities. 13 That said, it seems that we are heading in the right direction. Similar to arthroscopic shoulder stabilization, which was initially met with resistance and has now superseded open Bankart repair, hip arthroscopy may eventually replace PAO for soft-tissueerelated hip instability and femoroacetabular impingement in patients with borderline hip dysplasia.…”