TY - JOUR
T1 - The dysplastic and unstable hip
T2 - A responsible balance of arthroscopic and open approaches
AU - Nepple, Jeffrey J.
AU - Clohisy, John C.
PY - 2015/11/3
Y1 - 2015/11/3
N2 - The treatment of young adult hip disorders, including hip dysplasia, has evolved significantly in the last decade. The association of hip dysplasia with hip osteoarthritis is well accepted, but remains based on basic radiographic parameters. Our understanding of the complexity and variability of hip dysplasia continues to evolve. As the clinical presentation of mild and borderline acetabular dysplasia is very similar to that of other young adult hip disorders, such as femoroacetabular impingement, a thorough history, physical examination, and radiographic evaluation are important to properly diagnose these patients. Acetabular reorientation via the periacetabular osteotomy has become the most common treatment for acetabular dysplasia with good outcomes reported at over 20 years postoperatively. The treatment of intraarticular labrochondral pathology and femoral head-neck offset abnormalities at the time of periacetabular osteotomy has become more common place with the theoretical goal of improving longterm outcomes. The borderline dysplastic hip remains a controversial topic, with significant overlap with other causes of hip microinstability such as connective tissue laxity. In the current article, we present a relevant review of the literature and a balanced approach to the treatment of acetabular dysplasia.
AB - The treatment of young adult hip disorders, including hip dysplasia, has evolved significantly in the last decade. The association of hip dysplasia with hip osteoarthritis is well accepted, but remains based on basic radiographic parameters. Our understanding of the complexity and variability of hip dysplasia continues to evolve. As the clinical presentation of mild and borderline acetabular dysplasia is very similar to that of other young adult hip disorders, such as femoroacetabular impingement, a thorough history, physical examination, and radiographic evaluation are important to properly diagnose these patients. Acetabular reorientation via the periacetabular osteotomy has become the most common treatment for acetabular dysplasia with good outcomes reported at over 20 years postoperatively. The treatment of intraarticular labrochondral pathology and femoral head-neck offset abnormalities at the time of periacetabular osteotomy has become more common place with the theoretical goal of improving longterm outcomes. The borderline dysplastic hip remains a controversial topic, with significant overlap with other causes of hip microinstability such as connective tissue laxity. In the current article, we present a relevant review of the literature and a balanced approach to the treatment of acetabular dysplasia.
KW - Acetabular dysplasia
KW - Arthroscopy
KW - Hip dysplasia
KW - Labral tear
KW - Osteoarthritis
KW - Periacetabular osteotomy
UR - http://www.scopus.com/inward/record.url?scp=84947062506&partnerID=8YFLogxK
U2 - 10.1097/JSA.0000000000000096
DO - 10.1097/JSA.0000000000000096
M3 - Review article
C2 - 26524552
AN - SCOPUS:84947062506
SN - 1062-8592
VL - 23
SP - 180
EP - 186
JO - Sports Medicine and Arthroscopy Review
JF - Sports Medicine and Arthroscopy Review
IS - 4
ER -