Do Ligamentum Teres Tears Portend Inferior Outcomes in Patients With Borderline Dysplasia Undergoing Hip Arthroscopic Surgery? A Match-Controlled Study With a Minimum 2-Year Follow-up
Authors: Chaharbakhshi EO, Perets I, Ashberg L, Mu B, Lenkeit C, Domb BG
DOI: 10.1177/0363546517710008
Background
Arthroscopic treatment of borderline dysplasia (LCEA 18°-25°) is complex due to subtle instability. The impact of concurrent ligamentum teres (LT) tears on surgical outcomes in this population has not been well studied.
Purpose
To determine whether LT tears are associated with worse outcomes, higher revision rates, or increased risk of conversion to total hip arthroplasty (THA) in borderline dysplastic patients undergoing hip arthroscopy.
Methods
A cohort of patients with borderline dysplasia who underwent hip arthroscopy with labral treatment and capsular plication was analyzed. Patients with LT tears were pair-matched to those without tears based on key demographics and intraoperative factors. Patient-reported outcome scores were assessed preoperatively and at a minimum 2-year follow-up.
Key Findings
- 30 of 63 patients (48%) had LT tears; 20 patients in each group were matched.
- The LT tear group showed a non-significant trend toward lower postoperative mHHS and NAHS scores (P = .09).
- Revision rate was higher in the LT tear group (5 vs. 1).
- 15% of LT tear patients required conversion to THA; none in the control group did.
- No significant baseline or procedural differences between groups.
What this means for providers
Ligamentum teres tears in borderline dysplastic hips may indicate more advanced instability and could be associated with slightly worse outcomes, greater revision risk, and a higher likelihood of THA. These findings suggest that the presence of LT tears may warrant consideration of adjunctive or alternative procedures, such as LT reconstruction or periacetabular osteotomy, during surgical planning.