Surgical Outcomes in the Treatment of Concomitant Mild Acetabular Dysplasia and Femoroacetabular Impingement: A Systematic Review

Tang, Hao-Che; Dienst, Michael

doi:10.1016/j.arthro.2019.11.122

Cited by 16 publications

(8 citation statements)

References 54 publications

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“…However, favorable outcomes have been reported later by various studies suggesting that hip arthroscopy may have a role in patients with FAI and borderline dysplasia. [3][4][5][6] Traditionally, the lateral center-edge angle has been used to determine hip dysplasia, and a lateral centeredge angle between 15 and 25 suggests the presence of borderline dysplasia. 5,6 Recently, Wyatt et al 7 have introduced the FEAR (femoro-epiphyseal acetabular roof) index as a new measure to determine borderline dysplasia.…”

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confidence: 99%

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

Hohmann¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Section: See Related Article On Page 1509mentioning

confidence: 99%

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

Hohmann¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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“…Although there is a general consensus that hip dysplasia with a lateral center edge angle (LCEA) <18 should be treated with realignment of acetabular coverage by acetabular reorientation, there is still controversy as to whether milder forms of dysplasia, or so-called borderline hips with an LCEA between 18 and 25 , should be treated with arthroscopy or acetabular reorientation. 1,2 Identifying whether the problem is related to dysplasia or caused by femoroacetabular impingement syndrome (FAIS) is essential.…”

Section: See Related Article On Page 374mentioning

confidence: 99%

“…8 Furthermore, it has been shown that some improvements are present after arthroscopy in borderline hips, but these improvements are not achieved in all patients. 1,2 I am firmly convinced that a crucial factor in treating a borderline hip is recognizing whether the hip is stable or unstable. This has also been postulated by Wyatt et al, who described the femoro-epiphyseal acetabular roof (FEAR) index to help decide whether a hip should be considered stable or unstable.…”

Section: See Related Article On Page 374mentioning

confidence: 99%

Editorial Commentary: Hip Dysplasia—Arthroscopic Femoroacetabular Impingement Versus Periacetabular Osteotomy: Do Not FEAR the Size of the Next Step

Zimmerer¹

2022

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Hip dysplasia is characterized by inadequate acetabular coverage of the femoral head. There is a consensus that hip dysplasia with a lateral center edge angle (LCEA) less than18 should be treated with realignment of acetabular coverage by acetabular osteotomy, but there is controversy whether milder, borderline dysplasia with an LCEA between 18 and 25 should be treated with arthroscopy or acetabular reorientation. Identifying whether the problem is related to dysplasia or femoroacetabular impingement syndrome is essential, and a crucial factor is whether the hip is unstable. A femoroepiphyseal acetabular roof (FEAR) index with a cutoff value of 2 predicts hip stability with 90% probability, even with a normative LCEA. In addition, according to the anterior-wall index (AWI), the anterior acetabular border should cross onto the middle third of the medial femoral head radius on a line that runs parallel to the femoral neck axis through the center of the femoral head. A reduced AWI suggests a deficient anterior rim. Next, lateral labrum length correlates with the FEAR index and anterior labrum length with AWI, i.e., anterior dysplasia. Consequently, the lateral labrum increases in size with progressive instability, and the anterior labrum increases in size with decreased anterior coverage. Threshold values for labrum size should be defined to guide clinical decision making. Ultimately, we require an algorithm to guide arthroscopy versus bony correction.

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“…The direct cause of symptoms in BDDH is soft tissue pathology rather than osseous structures abnormality [ 4 ]. With the recent advances in hip arthroscopy instrumentation and techniques, the surgical indications have gradually expanded, arthroscopic treatment of borderline dysplasia could provide satisfying benefits [ 5 , 6 ], but the outcomes could be influenced by some risk factors [ 7 – 9 ], such as broken Shenton line, osteoarthritis, and Tӧnnis angle > 15°.…”

Section: Introductionmentioning

confidence: 99%

Central acetabular osteophytes (CAO) are more prevalent in the borderline developmental dysplastic hip (BDDH) patients: a propensity-score matched CT study

Yang

Huang

et al. 2022

J Orthop Surg Res

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Background The acetabular fossa often showing the first signs of degeneration, Central acetabular osteophytes (CAO) have been increasingly recognized during hip arthroscopy. The purpose of this study was to investigate the condition of CAO in BDDH hips and compare cotyloid fossa size between the BDDH and the non-BDDH hips on CT images. Methods We performed a retrospective analysis of prospectively collected data of hip CT images of FAI or labral injury patients. A 1:2 propensity-score matched observational study comparing the linear length of cotyloid fossa was analyzed. Cotyloid fossa width (CFW) and cotyloid notch width (CNW) were measured on axial images, cotyloid fossa height (CFH) and cotyloid fossa depth (CFD) were measured on coronal images. Within the CAO patients, we performed central acetabular decompression (CAD) and then observed the morphology change in fossa. Results Propensity-score matching yielded 61 BDDH hips and 122 non-BDDH hips. BDDH hips had a higher prevalence of CAO and a decreased linear length of cotyloid fossa (CFW, CFH and CNW). In the BDDH group, 33 hips underwent CAD, postoperative CFW, CFH and CNW were significantly increased (p < .001 for all), and had no statistical difference compared with the non-BDDH hips (p = .193, p = .132, p = .421, respectively). Conclusion BDDH hips had a significantly higher prevalence of CAO than adequate acetabular coverage hips. After the procedure of CAD, BDDH hips were found to have acetabular parameters (CFW, CFH, CNW) and were restored to that of the control hips.

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Surgical Outcomes in the Treatment of Concomitant Mild Acetabular Dysplasia and Femoroacetabular Impingement: A Systematic Review

Cited by 16 publications

References 54 publications

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

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

Editorial Commentary: Hip Dysplasia—Arthroscopic Femoroacetabular Impingement Versus Periacetabular Osteotomy: Do Not FEAR the Size of the Next Step

Central acetabular osteophytes (CAO) are more prevalent in the borderline developmental dysplastic hip (BDDH) patients: a propensity-score matched CT study

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