The treatment of hip instability with arthroscopic capsular plication

Atraumatic microinstability of the hip appears to be a cause of intra-articular pathology, in particular a tear of the anterior labrum of the acetabulum. The aim of this study was to assess a consecutive series of patients with atraumatic microinstability of the hip that had resulted in pathology of the anterior labrum and articular cartilage of the acetabulum, treated by hip arthroscopy and capsular plication without any combined bony procedures.
32 patients underwent hip arthroscopy and suture plication of the joint capsule for the treatment of hip instability, without any accompanying bone resection of the acetabulum or the proximal femur, between November 2009 and November 2012, and were followed up for a minimum of 12 months. The patients were assessed clinically, before surgery and after surgery for up to 36 months, and the modified Harris hip score and iHOT outcome scores were used for their evaluation. The comparison was made using the centre-edge angle, the Tonnis angle, the findings on clinical examination and the demographic characteristics.
There was a significant improvement in the hip outcome scores at final review. On comparing the patients with mild hip dysplasia with those without dysplasia, there was no significant difference in the clinical outcome at any point of follow-up. There was no significant correlation between the patient's age, the duration of preoperative symptoms, previous arthroscopy of the contralateral hip, the nature of the onset of symptoms, the centre-edge angles, the Tonnis angle or the preoperative clinical findings and the clinical outcome at final review.
The authors concluded that isolated arthroscopic suture plication of the joint capsule performed for the treatment of hip instability resulted in improvement in pain and function in these patients at a minimum follow-up of one year.
Source: “Knee Surgery, Sports Traumatology, Arthroscopy”, November 2016