Role and indications of hip arthroscopy for hip dysplasia

Abstract

Hip dysplasia is primarily a problem of instability of the native hip. Multiple structures are involved in the maintenance of hip stability, and successful treatment requires assessment of stabilizing structures. Intra-articular pathology, including labral tears, is common in patients with hip dysplasia, though cannot always be addressed through open surgical techniques. Traditional treatment has focused on redirectional osteotomies to improve bony coverage and stability of the native hip. Hip arthroscopy can provide an additional method of assessing and treating intra-articular pathology in the dysplastic hip. Isolated hip arthroscopy has traditionally been associated with high rates of treatment failure and even occasionally iatrogenic instability. Novel techniques including arthroscopic capsular plication, labral augmentation/reconstruction, or acetabular bone grafting in highly selected cases with less severe bony deformities may be possible. The role of arthroscopy to address intra-articular pathology as an adjunct to redirectional osteotomies appears promising though requires further study to assess its clinical benefit.