Borderline Hip Dysplasia - Best Treated with Hip Arthroscopy or Periacetabular Osteotomy?

IF 2.9 2区 医学 Q1 ORTHOPEDICS Current Reviews in Musculoskeletal Medicine Pub Date : 2024-09-28 DOI:10.1007/s12178-024-09928-5
Erin S Wilson, Kyle R Wagner, Andrea M Spiker
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Abstract

Purpose of review: As the field of hip preservation evolves, the diagnosis of borderline dysplasia (defined as a lateral center edge angle between 18°-25°) has shown itself to be one of the more challenging diagnoses to treat. As the nuances of acetabular coverage have come to light, the question of whether borderline hip dysplasia is best treated with isolated hip arthroscopy, periacetabular osteotomy, or whether a combined procedure is best, is now top of mind. The goal of these procedures is to not only improve patient symptoms, but to correct underlying pathology and ideally slow the development of hip osteoarthritis. The purpose of this review is to summarize the recent literature and clinical findings regarding both isolated hip arthroscopy and periacetabular osteotomy in the surgical management of borderline hip dysplasia.

Recent findings: Current research demonstrates improved postoperative clinical outcome scores for both patients who had isolated hip arthroscopy in the setting of borderline hip dysplasia and for those patients who underwent periacetabular osteotomy. Mid-term outcomes for patients in both groups have showed low rates of conversion to total hip arthroplasty. No gold standard in the surgical management of borderline hip arthroscopy exists. Improved clinical outcomes have been seen postoperatively in patients who undergo hip arthroscopy and in patients who undergo periacetabular osteotomy. Successful clinical outcomes seem to rely on treatment of the underlying clinical pathology and are largely based on the appropriate surgical indications and appropriate surgical techniques. Surgical decision making in this patient population should be individualized based on a comprehensive evaluation of the patient.

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边缘性髋关节发育不良--最佳治疗方法是髋关节镜还是髋关节周围截骨术?
综述的目的:随着髋关节保护领域的发展,边缘性发育不良(定义为外侧中心边缘角度在 18°-25° 之间)的诊断已成为治疗中更具挑战性的诊断之一。随着髋臼覆盖的细微差别逐渐显现,边界线髋关节发育不良的最佳治疗方法是孤立的髋关节镜手术、髋臼周围截骨术,还是联合手术,现在已成为人们最关心的问题。这些手术的目的不仅是改善患者的症状,还要纠正潜在的病理变化,最好能延缓髋关节骨性关节炎的发展。本综述旨在总结有关孤立髋关节镜手术和髋臼周围截骨术在手术治疗边缘性髋关节发育不良方面的最新文献和临床发现:目前的研究表明,在边缘型髋关节发育不良的情况下,接受孤立髋关节镜手术的患者和接受髋臼周围截骨术的患者术后临床效果评分均有所改善。两组患者的中期疗效均显示,转为全髋关节置换术的比例较低。对于边缘髋关节镜手术治疗,目前尚无金标准。接受髋关节镜手术和髋臼周围截骨术的患者术后临床疗效有所改善。成功的临床疗效似乎取决于对潜在临床病理的治疗,并在很大程度上取决于适当的手术适应症和适当的手术技术。针对这类患者的手术决策应在对患者进行全面评估的基础上因人而异。
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来源期刊
CiteScore
7.50
自引率
2.40%
发文量
64
期刊介绍: This journal intends to review the most significant recent developments in the field of musculoskeletal medicine. By providing clear, insightful, balanced contributions by expert world-renowned authors, the journal aims to serve all those involved in the diagnosis, treatment, management, and prevention of musculoskeletal-related conditions. We accomplish this aim by appointing authorities to serve as Section Editors in key subject areas, such as rehabilitation of the knee and hip, sports medicine, trauma, pediatrics, health policy, customization in arthroplasty, and rheumatology. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. We also provide commentaries from well-known figures in the field, and an Editorial Board of more than 20 diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
期刊最新文献
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