Favorable results seen for borderline dysplasia, ligamentum teres tears after hip arthroscopy
Patients with borderline dysplasia and ligamentum teres tears showed favorable patient-reported outcomes after hip arthroscopy surgery, according to results of a published study.
"While peri-acetabular osteotomy remains the treatment of choice for the unstable hip in the setting of dysplasia, this raises the possibility that ligamentum teres (LT) reconstruction, particularly in the non-dysplastic population, may play a role in stabilizing the hip,” Benjamin G. Domb, MD, of the American Hip Institute Research Foundation in Des Plaines, Illinois, and corresponding author, told Healio Orthopedics.
Domb, David R. Maldonado, MD, and colleagues collected data for patients who underwent hip arthroscopy surgery between September 2008 and August 2013. Patients with borderline dysplasia and LT tears of 50% or more (n=24) were grouped 1:1 to patients without borderline dysplasia without LT tears (n=24). The control group included patients without an LT tear, and the LT tear group included patients with an LT tear of 50% or more.
All patients underwent a comprehensive preoperative physician examination to assess range of motion, strength and instability. Nonoperative treatment included rest, physical therapy, activity modification and NSAIDs. Patients whose hips did not improve through nonoperative treatment were recommended for surgery.
Results showed 5-year postoperative patient-reported outcomes were comparable in both groups. The control group showed a superior Veterans RAND 12-Item Health Survey mental and SF-12 mental scores. Patients without an LT tear were significantly more likely to achieve the patient-acceptable symptomatic state for the modified Harris hip score (100% and 75%, respectively).
“Improvement in outcomes at midterm follow-up can be achieved regardless of LT status,” Domb said. “Borderline dysplastic patients with intact LT showed higher scores for Veterans RAND 12-Item Health Survey Mental Component and short-form 12 mental health, but more importantly, were significantly more likely to achieve the patient acceptable symptomatic state for the modified Harris hip score.” - By Erin T. Welsh
Disclosures: Domb reports receiving numerous ownership interests, research support, consulting fees, education support, speaking fees and is a board member of the American Hip Institute, Arthroscopic Association of North America’s Learning Center Committee and the journals Arthroscopy and Journal of Hip Preservation Surgery. Please see the study for all other authors’ relevant financial disclosures.