17.
Outcome of Hip Arthroscopy after Peri-Acetabular Osteotomy
Bent Lund, Torsten Nielsen, Svend Erik Christiansen, Martin Lind
Div. Sportstrauma, Orthopedic Dept Aarhus University Hospital; Div.
Sportstrauma, Orthopedic Dept, Aarhus University Hospital; Div.
Sportstrauma, Orthopedic Dept, Aarhus University Hospital; Div.
Sportstrauma, Orthopedic Dept, Aarhus University Hospital
Background:
Patients with Developmental Dysplasia of the Hip (DDH) are
frequently treated Peri- Acetabular Osteotomy (PAO). These patients can have
pathologic changes of labrum and cartilage in the hip joint, which are not
addressed by the PAO procedure. Hip arthroscopy is a possible treatment
method for continued symptoms after PAO
Purpose / Aim of Study:
The purpose of this study was to describe the
arthroscopic findings and the short-term clinical outcome of hip arthroscopy in
patients with DDH that have continued symptoms after PAO.
Materials and Methods:
Data is based on a retrospective case series of 17
DDH patients with a previous PAO procedure operated with hip arthroscopy
2008
to 2010. Patients had a mean age of 37 years at time of surgery. 88 %
were female. To evaluate hip function and pain level at 1- year follow-up HOS
(
Hip Outcome Score) and pain scores were used. Total hip arthroplasty (THA)
reoperation within one- years follow-up indicated a failure.
Findings / Results:
Labrum tears were seen in 94 % of patients. Cartilage
lesions (ICRS grade 2 and above) were seen at the Acetabulum and Caput in
71 %
and 18 % of cases respectively. Pain levels did not decrease form pre-
operatively to follow up. The mean preoperative HOS was 60 (40-76) and
mean postoperative HOS score was 61 (38- 96). (NS). 24 % (4 patients) had a
THA within the follow-up period. It was patients with femoral head
deformities and joint space < 3 mm that went on to total hip arthroplasty
Conclusions:
In the dysplastic hip patient treated with PAO, hip arthroscopy
can address labral and cartilage lesions. There was no positive impact on pain
and patient evaluated hip function of arthroscopic treatment. A relatively high
proportion of patients went on to total hiparthroplasty. Whether hip
arthroscopy can be used for treatment of continued symptoms after PAO needs
further study.
