No Difference in Patient-Reported Outcomes for Periacetabular Osteotomy and Hip Arthroscopy With Capsular Plication in the Setting of Borderline Hip Dysplasia: A Propensity-Matched Multicenter Study With Minimum 5-Year Follow-Up

No Difference in Patient-Reported Outcomes for Periacetabular Osteotomy and Hip Arthroscopy With Capsular Plication in the Setting of Borderline Hip Dysplasia: A Propensity-Matched Multicenter Study With Minimum 5-Year Follow-Up

Authors: Andronic O, Chaharbakhshi EO, Zingg PO, Germann C, Rahm S, Lall AC, Domb BG

Journal: Arthroscopy, March 2024

DOI: 10.1016/j.arthro.2023.06.045

Objective

Compare 5-year outcomes of hip arthroscopy (HA) with capsular plication versus periacetabular osteotomy (PAO) in patients with borderline hip dysplasia.

Key Findings

• Both HA and PAO yield similar, significant improvements in hip pain and function.
• PAO patients had longer follow-up and a higher incidence of subsequent surgeries, mostly hardware removals.
• Revision surgery rates were higher after HA but not statistically different from PAO.
• No difference in conversion to total hip arthroplasty (THA) between groups.

Conclusion

HA with capsular plication and PAO provide comparable long-term outcomes in borderline hip dysplasia with low revision rates.

What Does This Mean for Providers?

• Both surgical options can be effective; decision-making should consider patient-specific factors and preferences.
• Counsel PAO patients about the potential need for secondary procedures such as hardware removal.
• Monitor HA patients closely for signs indicating the need for revision surgery.
• Both approaches have low THA conversion rates, supporting their use as durable joint preservation strategies.