ePoster #900 - ISHA Annual Scientific Meeting 2016

Clinical Outcomes Of Hip Arthroscopy In Radiographically Diagnosed Retroverted Acetabula

David E. Hartigan, MD, Westmont, IL UNITED STATES
Itay Perets, MD, Westmont, IL UNITED STATES
Mary R. Close, BS, Westmont, IL UNITED STATES
John P. Walsh, MA, Westmont, IL UNITED STATES
Edwin Chaharbakhshi, BS, Hinsdale, IL UNITED STATES
Benjamin G. Domb, MD, Chicago, IL UNITED STATES

American Hip Institute, Westmont, IL, UNITED STATES

FDA Status Not Applicable

Summary: : This study demonstrates that hip arthroscopy can successfully treat femoro-acetabular impingement associated with a globally retroverted acetabula at a minimum of two-year follow-up.

Abstract:
Background: Symptomatic global retroversion of the acetabulum as diagnosed on plain radiographs of the pelvis has traditionally been treated with reverse peri-acetabular osteotomy, which improves posterior under-coverage, and eliminates the anterior pincer lesion. There is a paucity of literature on hip arthroscopy in this group secondary to theoretical concern of iatrogenic dysplasia, subsequent instability, and arthritis. Purpose: To evaluate the outcomes of hip arthroscopy in patients diagnosed with acetabular retroversion with plain radiographs using patient reported outcomes, visual analog scale, patient satisfaction, and comparing preoperative and postoperative Tönnis grade. Methods: preoperative and postoperative data were prospectively collected and retrospectively reviewed on patients who underwent hip arthroscopy at one institution between June 2008 and February 2012. Patients with adequate radiographs of the pelvis demonstrating global acetabular retroversion treated with arthroscopic surgery were analyzed. Complications were tracked in this institution’s database. The mHHS, NAHS, HOS-ADL, HOS-SSS, and VAS were analyzed preoperatively and at latest follow-up. Level of satisfaction was also assessed ranking postop satisfaction from 0-10. The preoperative and postoperative alpha angle, LCEA, ACEA, crossover %, and Tönnis grade were recorded. Tönnis grade at latest follow-up was utilized to determine progression of osteoarthritis. Results: 82 patients were identified that met listed criteria with an average age of 23 and average follow-up of 39 months. These patients showed statistically significant improvement in mHHS (65-81), NAHS (65-85), HOS-ADL (69-88), HOS-SSS (47-76) and VAS (5.9-2.5)(p=<.0001). They had an average satisfaction with surgery of 7.4. There were three minor complications, none of which required re-operation. One patient underwent hip arthroplasty at 6 months after hip arthroscopy. There were 15 patients that had greater than two year radiographic follow-up, none of these patients had an increase in Tönnis grade compared to their preoperative state. Conclusion: This study demonstrates that hip arthroscopy can successfully treat femoro-acetabular impingement associated with a globally retroverted acetabula at a minimum of two-year follow-up. Survivorship was 99% at two years with one patient requiring further surgery in the form of hip arthroplasty. There was no noted progression of Tönnis grade at final follow-up. The procedure was extremely safe with a minor complication rate of 3.6%.