TY - JOUR
T1 - Editorial Commentary
T2 - At the Intersection of Borderline Dysplasia and Femoroacetabular Impingement—Which Way Should We Turn?
AU - Nepple, Jeffrey J.
N1 - Publisher Copyright:
© 2019 Arthroscopy Association of North America
PY - 2020/4
Y1 - 2020/4
N2 - Borderline acetabular dysplasia remains a controversial topic in hip preservation, with poor current comparative literature to guide accurate diagnosis and treatment decision making. Borderline dysplasia represents a “transitional acetabular coverage” pattern between more classic acetabular dysplasia and normal coverage. Traditionally, borderline dysplasia has been defined by a lateral center-edge angle between 20° and 25°, whereas more recently, some authors have used 18° to 25°. Treatment decisions between isolated hip arthroscopy (addressing labral tears, femoroacetabular impingement morphology, and capsular laxity) and periacetabular osteotomy (improving joint stability, often combined with arthroscopy) remain challenging because the fundamental mechanical diagnosis (instability vs femoroacetabular impingement) can be difficult to determine clinically. Obtaining an accurate diagnosis to direct surgical treatment relies on comprehensive assessment of additional bony anatomy features (including femoral version) and patient characteristics (including sex, soft-tissue laxity, and range of motion). Future research efforts in borderline dysplasia should better characterize the role of disease- and patient-specific factors that will inform accurate diagnoses, leading to the development of optimal treatment strategies in distinct patient subgroups through comparison of treatment outcomes.
AB - Borderline acetabular dysplasia remains a controversial topic in hip preservation, with poor current comparative literature to guide accurate diagnosis and treatment decision making. Borderline dysplasia represents a “transitional acetabular coverage” pattern between more classic acetabular dysplasia and normal coverage. Traditionally, borderline dysplasia has been defined by a lateral center-edge angle between 20° and 25°, whereas more recently, some authors have used 18° to 25°. Treatment decisions between isolated hip arthroscopy (addressing labral tears, femoroacetabular impingement morphology, and capsular laxity) and periacetabular osteotomy (improving joint stability, often combined with arthroscopy) remain challenging because the fundamental mechanical diagnosis (instability vs femoroacetabular impingement) can be difficult to determine clinically. Obtaining an accurate diagnosis to direct surgical treatment relies on comprehensive assessment of additional bony anatomy features (including femoral version) and patient characteristics (including sex, soft-tissue laxity, and range of motion). Future research efforts in borderline dysplasia should better characterize the role of disease- and patient-specific factors that will inform accurate diagnoses, leading to the development of optimal treatment strategies in distinct patient subgroups through comparison of treatment outcomes.
UR - http://www.scopus.com/inward/record.url?scp=85082614633&partnerID=8YFLogxK
U2 - 10.1016/j.arthro.2020.01.023
DO - 10.1016/j.arthro.2020.01.023
M3 - Editorial
C2 - 32247413
AN - SCOPUS:85082614633
SN - 0749-8063
VL - 36
SP - 1185
EP - 1188
JO - Arthroscopy - Journal of Arthroscopic and Related Surgery
JF - Arthroscopy - Journal of Arthroscopic and Related Surgery
IS - 4
ER -