Purpose: To compare minimum 2-year outcomes of concomitant hip arthroscopy (HA) with periacetabular osteotomy (PAO) versus isolated HA with capsular plication in patients with borderline hip dysplasia (BHD).
Methods: Data were retrospectively reviewed for patients who underwent surgery for femoroacetabular impingement in the setting of BHD between September 2008 and December 2021. Included patients had preoperative and minimum 2-year patient reported outcomes scores (PROs). Patients who underwent staged PAO and HA comprised the PAO group. Patients who underwent isolated HA with capsular plication comprised the HA group. Matching occurred in a 1:1 ratio based on age, sex, BMI, and Tonnis Grade.
Results: 74 hips were included. The HA group's mean postoperative values for the mHHS, NAHS, HOS-SSS, and VAS were, respectively: 90.32 ± 12.39, 89.46 ± 11.57, 81.47 ± 20.54, and 1.74 ± 1.89. These PRO values for the PAO group were: 90.69 ± 13.46, 91.59 ± 10.80, 82.20 ± 21.23, and 1.49 ± 1.94. The HA group met MCID for the mHHS (89.19%), NAHS (86.49%), and HOS-SSS (72.97%) at similar rates compared to the PAO group (89.19%, 86.49%, and 78.38%). Rates of achieving PASS in the HA group for these PROs were 86.49%, 72.97%, and 67.57%, while in the PAO group, rates were 86.49%, 78.38%, and 70.27%. Rates of achieving MOI in the HA group for these PROswere 81.1%, 75.68%, and 70.27%, while in the PAO group, rates were 75.68%, 75.68%, and 70.27%. 10.81% of the PAO group and 5.41% of the HA group experienced complications (p = 0.67).
Conclusion: PAO with concomitant HA and isolated HA with capsular plication in the setting of BHD yielded favorable and comparable outcomes. A high percentage of patients in both HA and PAO groups reached clinically relevant thresholds, with similar rates of revision and conversion to arthroplasty at minimum 2-year follow-up.
Level Of Evidence: Level III: Retrospective comparative study.
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