Arthroscopy for Labral Tears in Patients with Developmental Dysplasia of the Hip: A Cautionary Note

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Abstract

Patients with developmental dysplasia of the hip may present with acetabular rim overloading, labral hypertrophy, and tear. Our hypothesis was that isolated arthroscopic treatment of labral tear is likely to fail in most patients. We investigated 34 patients who underwent at least one arthroscopy of the hip for labral tear. Developmental hip dysplasia or other morphologic abnormalities of the hip were confirmed in all patients. Arthroscopy failed to relieve pain in 24 patients. We observed accelerated arthritis in 14 patients and migration of the femoral head in 13 patients. Sixteen patients underwent further surgery (further surgeries included periacetabular osteotomy [6 patients], femoroacetabular osteoplasty [7 patients], and total hip arthroplasty [3 patients]). At the latest follow-up, all patients but one were pain-free. Patients with evidence of abnormal hip morphologies may not benefit from hip arthroscopy and isolated treatment of the labrum; in fact, the latter may accelerate the process of arthritis in some patients.

Section snippets

Patient Population

This study from 2 institutions identified all patients with morphologic abnormality of the hip who had undergone hip arthroscopy for the repair and/or excision of the labrum. The cohort consists of 34 patients (36 hips), 22 women and 12 men, with a mean age of 34 years (range, 19-51 years) at the time of arthroscopy. All surgeries were performed at university-affiliated institutions where detailed electronic data are collected in a prospective manner. The clinical and radiographic records of

Results

Radiographic evaluation confirmed the presence of morphologic abnormalities of the hip in all cases, with DDH in 30 hips and acetabular retroversion in 6 hips. Femoroacetabular impingement (due to an underlying abnormal morphology of the acetabulum and/or femoral head) was present in 7 hips. Magnetic resonance arthrogram confirmed the presence of labral tears and/or degeneration in all cases.

All patients were followed clinically and radiologically for at least 1 year after arthroscopy. No

Discussion

Developmental dysplasia of the hip is a relatively common condition that, depending on the geographic location, can be seen in up to 80% of patients with end-stage arthritis of the hip [9]. Because of decreased surface area of contact and increased joint reaction forces, patients with dysplasia ultimately develop arthritis of the hip and seek hip arthroplasty. Patients with DDH may also come to the attention of orthopedic surgeons because of the presence of labral pathologies and/or chondral

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  • Cited by (0)

    JP received research fund support from Stryker Orthopaedics Mahva, NJ.

    Institutional ethical board review consent was obtained for conducting the following study.

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