Achieving Successful Outcomes in High-Level Athletes With Borderline Hip Dysplasia Undergoing Hip Arthroscopy With Capsular Plication and Labral Preservation: A Propensity-Matched Controlled Study

Achieving Successful Outcomes in High-Level Athletes With Borderline Hip Dysplasia Undergoing Hip Arthroscopy With Capsular Plication and Labral Preservation: A Propensity-Matched Controlled Study

Authors: Jimenez AE, Monahan PF, Miecznikowski KB, Saks BR, Ankem HK, Sabetian PW, Lall AC, Domb BG

DOI: 10.1177/03635465211021001

Background

Borderline hip dysplasia (BD) predisposes athletes to hip instability and labral pathology. Data on arthroscopic outcomes in this population remain limited.

Methods

Comparative study of high-level athletes with BD undergoing hip arthroscopy including capsular plication and labral preservation, matched to athletes with normal hips. Outcomes measured were PROs and return-to-sport rates.

Key Findings

• BD athletes had significant functional improvement and a high RTS rate (~81%), comparable to controls.
• Capsular plication was utilized more frequently in BD cases, likely contributing to stability and favorable outcomes.

Conclusions

Hip arthroscopy with capsular plication and labral preservation is effective in athletes with borderline dysplasia, supporting return to sport and symptom improvement.

What Does This Mean for Providers?

• Consider capsular plication routinely in arthroscopic treatment of BD to address instability.
• Inform athletes with BD of the favorable prognosis with proper surgical technique.
• Use propensity-matched data to counsel patients on expected outcomes similar to those with normal hip anatomy.
• Maintain a high index of suspicion for instability and tailor surgical strategy accordingly.