Is Hip Arthroscopy Effective in Patients With Combined Excessive Femoral Anteversion and Borderline Dysplasia? A Match-Controlled Study
Authors: Chaharbakhshi EO, Hartigan DE, Perets I, Domb BG
Background
Excessive femoral anteversion (EFA) combined with borderline dysplasia (EFABD) presents a complex biomechanical challenge, with unclear benefits from arthroscopic treatment alone.
Methods
Patients with EFABD undergoing hip arthroscopy were compared to matched controls without these anatomical factors. Functional outcomes, patient satisfaction, and rates of secondary surgery were evaluated.
Key Findings
- EFABD patients had worse functional outcomes and higher dissatisfaction.
- 33.3% of EFABD patients required additional procedures, compared to 4.2% in controls.
- Hip arthroscopy alone may be insufficient in this subgroup due to underlying instability and rotational abnormalities.
What Does This Mean for Providers?
- Surgeons should approach EFABD cases with caution. These patients may not benefit from isolated arthroscopic intervention.
- A multidisciplinary or staged approach—including consideration of periacetabular or femoral osteotomy—may be more appropriate.
- Preoperative planning should include detailed rotational profile assessment and instability workup.