ePoster #120 - ISHA Annual Scientific Meeting 2016
The Role of Arthroscopic Hip Surgery in the Setting of Acetabular Dysplasia
Brian D. Giordano, MD, Rochester, NY UNITED STATES
Kelly Lynne Adler, MEd, ATC, Pittsford, NY UNITED STATES
University of Rochester, Rochester, NY, UNITED STATES
FDA Status Not Applicable
Summary: This purpose of this systematic review was to determine whether arthroscopic techniques offer value in the treatment of acetabular dysplasia and its associated pathomorphology.
Objective: Correction of acetabular dysplasia has traditionally relied on femoral and/or acetabular reorientation osteotomies; however, these procedures may not represent the optimal tool to adequately treat associated intra-articular pathology. Synovial, chondral, and labral pathology, as well as bony dysmorphology is common in the setting of acetabular dysplasia. Arthroscopic techniques may facilitate improved joint visualization and access to address intra-capsular pathology, but has not been fully explored in this population. This purpose of this systematic review was to determine whether arthroscopic techniques offer value in the treatment of acetabular dysplasia and its associated pathomorphology.
Methods: An exhaustive search of the existing literature was conducted according to PRISMA guidelines. Two databases (Pubmed and CINAHL) were selected to perform a search from January 1930 through April 2016 for published studies in the English language, concerning the utilization of hip arthroscopy with diagnostic and therapeutic intentions in individuals with acetabular dysplasia.
Results: 32 studies met our selection criteria and were classified within 5 different categories: Hip arthroscopy for screening, chondral mapping, and planning (8), Isolated arthroscopic treatment (13), Outcomes of hip arthroscopy after previous reorientation pelvic osteotomy for acetabular dysplasia (5), Arthroscopy followed by un-planned hip preservation surgery (4), and Combined arthroscopy and periacetabular osteotomy (PAO) (2).
Conclusion: Isolated hip arthroscopy in the setting of acetabular dysplasia may provide mid term improvements in pain and function, however, cannot be recommended as a definitive treatment option. Hip arthroscopy should be utilized with caution, due to risk for accelerated degenerative changes, progressive joint space narrowing, and femoral head subluxation or dislocation. Arthroscopic techniques, used as an adjunct to corrective pelvic procedures may improve long term outcomes and decrease progression of osteoarthritis.