TY - JOUR
T1 - Arthroscopic Disease Classification and Interventions as an Adjunct in the Treatment of Acetabular Dysplasia
AU - Ross, James R.
AU - Zaltz, Ira
AU - Nepple, Jeffrey J.
AU - Schoenecker, Perry L.
AU - Clohisy, John C.
PY - 2011/7/1
Y1 - 2011/7/1
N2 - Background: Treatment of hip dysplasia has focused on corrective osteotomy surgery, while hip arthroscopy remains controversial. Improved understanding of intra-articular disease patterns associated with hip dysplasia will help delineate the role of arthroscopy as an adjunct to osteotomy surgery for dysplastic hips. Purpose: The authors set out to describe the intra-articular disease patterns of patients undergoing combined hip arthroscopy and periacetabular osteotomy for the treatment of symptomatic acetabular dysplasia with associated mechanical symptoms. Secondly, they wanted to identify the potential role for arthroscopy in treating intra-articular problems as an adjunct to acetabular reorientation surgery. Study Design: Case series; Level of evidence, 4. Methods: Seventy-three hips in 71 patients undergoing arthroscopy for mechanical symptoms before a redirectional osteotomy of the acetabulum were reviewed. Radiographic findings of acetabular dysplasia were compared with intraoperative labral and chondral disease patterns. Arthroscopic interventions were recorded. Results: Labral tears and acetabular cartilage lesions were present in 65.8% and 68.5% of hips, respectively. Combined acetabular articular cartilage lesions and labral disease were observed in 58.9% of hips. When disease was present, acetabular labrum and chondral lesions were primarily located at the anterior (81.0%, 76.0%) and superolateral (66.7%, 84.0%) labrochondral junctions. A lateral center-edge angle <15° was associated with an increased likelihood of acetabular chondromalacia, as well as moderate to severe acetabular cartilage disease. An acetabular inclination of >20° was associated with an increased risk of larger labral tears (>2 cm). Sixty-three percent had at least 1 arthroscopic treatment of central compartment disease, most commonly acetabular chondroplasty (30.1%), partial labral resection (26.0%), and labral repair (16.4%). Conclusion: Acetabular rim disease is common in symptomatic acetabular dysplasia, and 63% of cases have a central compartment abnormality amenable to arthroscopic treatment. Lateral center-edge angle <15° and acetabular inclination >20° are associated with more severe labrochondral disease.
AB - Background: Treatment of hip dysplasia has focused on corrective osteotomy surgery, while hip arthroscopy remains controversial. Improved understanding of intra-articular disease patterns associated with hip dysplasia will help delineate the role of arthroscopy as an adjunct to osteotomy surgery for dysplastic hips. Purpose: The authors set out to describe the intra-articular disease patterns of patients undergoing combined hip arthroscopy and periacetabular osteotomy for the treatment of symptomatic acetabular dysplasia with associated mechanical symptoms. Secondly, they wanted to identify the potential role for arthroscopy in treating intra-articular problems as an adjunct to acetabular reorientation surgery. Study Design: Case series; Level of evidence, 4. Methods: Seventy-three hips in 71 patients undergoing arthroscopy for mechanical symptoms before a redirectional osteotomy of the acetabulum were reviewed. Radiographic findings of acetabular dysplasia were compared with intraoperative labral and chondral disease patterns. Arthroscopic interventions were recorded. Results: Labral tears and acetabular cartilage lesions were present in 65.8% and 68.5% of hips, respectively. Combined acetabular articular cartilage lesions and labral disease were observed in 58.9% of hips. When disease was present, acetabular labrum and chondral lesions were primarily located at the anterior (81.0%, 76.0%) and superolateral (66.7%, 84.0%) labrochondral junctions. A lateral center-edge angle <15° was associated with an increased likelihood of acetabular chondromalacia, as well as moderate to severe acetabular cartilage disease. An acetabular inclination of >20° was associated with an increased risk of larger labral tears (>2 cm). Sixty-three percent had at least 1 arthroscopic treatment of central compartment disease, most commonly acetabular chondroplasty (30.1%), partial labral resection (26.0%), and labral repair (16.4%). Conclusion: Acetabular rim disease is common in symptomatic acetabular dysplasia, and 63% of cases have a central compartment abnormality amenable to arthroscopic treatment. Lateral center-edge angle <15° and acetabular inclination >20° are associated with more severe labrochondral disease.
KW - chondromalacia
KW - dysplasia
KW - hip arthroscopy
KW - labral tear
UR - http://www.scopus.com/inward/record.url?scp=84855749575&partnerID=8YFLogxK
U2 - 10.1177/0363546511412320
DO - 10.1177/0363546511412320
M3 - Article
C2 - 21709035
AN - SCOPUS:84855749575
SN - 0363-5465
VL - 39
SP - 72S-78S
JO - American Journal of Sports Medicine
JF - American Journal of Sports Medicine
IS - 1_suppl
ER -