One Bony Morphology, Two Pathologic Entities: Sex-Based Differences in Patients With Borderline Hip Dysplasia Undergoing Hip Arthroscopy

Saks, Benjamin R.; Fox, James D.; Owens, Jade S.; Maldonado, David R.; Jimenez, Andrew E.; Ankem, Hari K.; Lall, Ajay C.; Domb, Benjamin G.

doi:10.1177/03635465211043510

Cited by 9 publications

(17 citation statements)

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“… 26 , 31 , 37 Similarly, cam deformity and higher alpha angles have been correlated with worse acetabular cartilage lesions, but similar rates of high-grade acetabular cartilage injury were observed in this study. 1 , 9 , 30 , 32 Prior literature by Saks et al 53 evaluated intraoperative findings and postoperative outcomes comparing male and female patients with borderline dysplasia undergoing primary hip arthroscopy for FAIS. In their study, similar outcomes were found at a minimum 2-year follow-up, but male patients demonstrated higher preoperative alpha angles and underwent acetabular microfracture at higher rates.…”

Section: Discussionmentioning

confidence: 99%

“…In their study, similar outcomes were found at a minimum 2-year follow-up, but male patients demonstrated higher preoperative alpha angles and underwent acetabular microfracture at higher rates. 53 …”

Section: Discussionmentioning

confidence: 99%

“…Generalized ligamentous laxity has been commonly reported in women undergoing primary hip arthroscopy. 51 , 53 In a study by Saadat et al, 51 women were reported to have a higher risk of generalized ligamentous laxity, defined as a Beighton score ≥4. In their patient population, 84.2% of patients with Beighton scores ≥1 were women, and 92.7% of those with Beighton scores ≥4 were women.…”

Section: Discussionmentioning

confidence: 99%

“…The present study’s finding of higher rates of capsular repair in female athletes may be explained by sex-based pathology differences that consequently require different treatment modalities. 51 , 53 …”

Section: Discussionmentioning

confidence: 99%

“…More specifically, sex-based differences are increasingly recognized, as female and male patients have unique pathologies that may require different treatments. 53 Male patients often demonstrate a higher prevalence of cam-type FAI, while female patients are more susceptible to microinstability. Given these differences, it is critical to study outcomes of hip arthroscopy with labral reconstruction in sex-based populations.…”

mentioning

confidence: 99%

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Sex-Based Differences in Athletes Undergoing Primary Hip Arthroscopy With Labral Reconstruction: A Propensity-Matched Analysis With Minimum 2-Year Follow-up

Owens

Lee

Jimenez

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: There is a paucity of literature comparing sex-based outcome differences in athletes after primary hip arthroscopy with labral reconstruction for femoroacetabular impingement syndrome (FAIS) and irreparable labral tears. Purpose: To report sex-based differences in clinical characteristics, patient-reported outcome (PRO) scores, and return-to-sports (RTS) rates in athlete who underwent primary hip arthroscopy with labral reconstruction. Study Design: Cohort study; Level of evidence, 3. Methods: Data were reviewed for recreational, organized amateur, high school, collegiate, and professional athletes who underwent primary hip arthroscopy with labral reconstruction for FAIS and irreparable labral tears between July 2014 and May 2019. Inclusion criteria included preoperative and minimum 2-year postoperative PRO scores (modified Harris Hip Score, Non-Arthritic Hip Score, Hip Outcome Score–Sports Specific Subscale, International Hip Outcome Tool [iHOT-12], and visual analog scale [VAS] for pain). Exclusion criteria were Tönnis grade >1, hip dysplasia (lateral center-edge angle, <18°), or prior ipsilateral hip surgery/conditions. Patients were divided into groups by sex and were propensity-matched in a 1:1 ratio by age, body mass index, graft type, labral tear size, and sports level. Results: A total of 101 hips were eligible, and 94 hips (93.1%) had a minimum 2-year follow-up. Twenty-nine female athlete hips were propensity-matched to 29 male athlete hips. Female athletes underwent higher rates of capsular repair (79.3% vs 24.1% for men; P < .001) and lower rates of acetabular microfracture (0.0% vs 20.7% for men; P = .024). Both female and male athletes experienced significant improvement on all PRO scores ( P < .001 for all), high RTS rates (women, 84% vs men, 80.8%), and high rates of achieving the minimal clinically important difference for the iHOT-12 and VAS pain (women, 88.5% vs men, 71.4% for both) and achieving the patient acceptable symptom state for the iHOT-12 (women, 88.5% vs men, 71.4%), with no significant difference between the sexes. Conclusion: Despite different clinical characteristics and surgical procedures, both female and male athletes undergoing primary hip arthroscopy with labral reconstruction had significant improvements in all PROs at the minimum 2-year follow-up, high RTS rates, and similar rates of achieving the minimal clinically important difference and patient acceptable symptom state.

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