Arthroscopic Capsular Plication and Labral Seal Restoration in Borderline Hip Dysplasia: 2-Year Clinical Outcomes in 55 Cases
Authors: Chandrasekaran S, Darwish N, Martin TJ, Suarez-Ahedo C, Lodhia P, Domb BG
Journal: Arthroscopy. 2017 Jul;33(7):1332–1340
DOI: 10.1016/j.arthro.2017.01.037
Background
In patients with borderline dysplasia, joint-preserving arthroscopic strategies are controversial. This study evaluates outcomes of arthroscopic labral preservation with minimal rim resection and capsular plication.
Methods
55 hips with LCEA 18°–25° treated arthroscopically with ≤2 mm rim resection, labral repair/reconstruction, and capsular plication. Excluded were patients with significant arthritis or deformity. Minimum 2-year follow-up assessed via mHHS, NAHS, HOS-ADL/SSS, VAS, satisfaction, revision, and complication rates.
Key Findings
- Significant improvements in all patient-reported outcomes (PROs) and pain scores.
- Mean satisfaction: 8.09/10.
- 11% underwent revision surgery; no conversions to THA.
- Labrum repaired in 37 cases, debrided in 17, and reconstructed in 1.
Conclusions:
Arthroscopic management with minimal rim trimming and capsular plication is effective in borderline dysplastic hips when performed with labral preservation.
What Does This Mean for Providers?
- In carefully selected borderline dysplasia cases, joint-preserving arthroscopic treatment can yield high satisfaction and improved function.
- Capsular plication and labral restoration are key to preserving stability.
- This approach may reduce the need for periacetabular osteotomy in some patients.