Open and Arthroscopic Treatment of Adult Hip Dysplasia: A Systematic Review
Authors: Lodhia P, Chandrasekaran S, Gui C, Darwish N, Suarez-Ahedo C, Domb BG
DOI: 10.1016/j.arthro.2015.07.022
Purpose
To compare outcomes and total hip arthroplasty (THA) conversion rates after arthroscopy, periacetabular osteotomy (PAO), or combined treatments for adult hip dysplasia.
Methods
- Systematic review of 10 studies covering 834 hips.
- Evaluated patient-reported outcomes and THA conversion rates.
Key Findings
- Arthroscopy had low THA conversion (4.8%) and was effective primarily in borderline dysplasia.
- PAO showed good outcomes for true dysplasia but higher THA conversion (12%).
- Combined procedures had limited data, with even higher THA conversion (17.7%).
What Does This Mean for Providers?
- Treatment choice should be tailored based on dysplasia severity:
- Arthroscopy is appropriate for borderline dysplasia with less invasiveness and low THA conversion.
- PAO remains the standard for true dysplasia despite higher conversion risk.
- Thorough radiographic assessment is essential for surgical planning and counseling patients on prognosis.