Abstract
Objective
To introduce a set of hip arthroscopic capsular management for patients with symptomatic Borderline Developmental Dysplasia of the Hip and evaluate its clinical outcomes at a mean 2-year follow-up.
Methods
A retrospective study was conducted on symptomatic BDDH patients who underwent hip arthroscopy for labrum tear from January 2020 to January 2024. Inclusion criteria were that hip arthroscopy with outside-in longitudinal capsulotomy and comprehensive capsular closure, which includes proximal capsular augmentation and anatomical repair of the zona orbicularis addition to the side-to-side plication, and had a minimum follow-up of 6 months. The exclusion criteria included inflammatory synovitis of the hip, infections and frank dysplasia. Demographic data, surgical details and patient-reported outcomes were collected and analyzed, including International Hip Outcome Tool 12 (iHOT-12) Score, Visual Analogue Score (VAS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC).
Result
Fifty-three patients were finally enrolled with an average age of 35.4±10.9 years and a mean follow-up of 2.6±1.5 years. Beside common findings such as labral tear, cartilage injure, and ligamentum teres injuries, a relative thinner anterior capsule was confirmed 4.6±1.0 mm. Comprehensive capsular closure was performed in all cases. Significant improvements were observed in iHOT-12 (44.6±8.2 VS 79.9±7.1), VAS (3.7±1.0 VS 1.1±0.8) and WOMAC (19.4±9.7 VS 9.7±4.0) from preoperative to the final follow-up (P < 0.0001). No significant complications were found in all patients.
Conclusion
Hip arthroscopy with outside-in longitudinal capsulotomy and comprehensive capsular closure provide a feasible and safe solution for BDDH, and it achieve good clinical outcomes in short term follow-up.