Background:Patients with borderline hip dysplasia (BHD) and concomitant femoroacetabular impingement syndrome (FAIS) have demonstrated similar outcomes at short- and midterm follow-up compared with equivalent patients without dysplasia. However, comparisons between these groups at long-term follow-up have yet to be investigated.Purpose:To compare long-term clinical outcomes between patients with BHD undergoing primary hip arthroscopy for FAIS versus matched control patients without BHD.Study Design:Cohort study; Level of evidence, 2.Methods:A retrospective cohort study was conducted on patients with BHD (lateral center-edge angle, 18°-25°) who underwent hip arthroscopy for FAIS between January 2012 and February 2013. Patients were propensity matched in a 1:3 ratio by age, sex, and body mass index to control patients without BHD who underwent primary hip arthroscopy. Groups were compared in terms of patient-reported outcomes (PROs) preoperatively and at 10 years postoperatively, including the Hip Outcome Score Activities of Daily Living subscale (HOS-ADL) and Sports subscale (HOS-SS), modified Harris Hip Score, 12-item International Hip Outcome Tool, visual analog scale (VAS) for pain and satisfaction. Achievement rates for minimal clinically important difference (MCID) and Patient Acceptable Symptom State (PASS) were compared between groups. Kaplan-Meier survivorship curves were assessed between groups.Results:At a mean follow-up of 10.3 ± 0.3 years, 28 patients with BHD (20 women; age, 30.8 ± 10.8 years) were matched to 84 controls who underwent primary hip arthroscopy. Both groups significantly improved from preoperative assessment in all PRO measures at 10 years ( P < .001 for all). PRO scores were similar between groups, aside from HOS-SS (BHD, 62.9 ± 31.9 vs controls, 80.1 ± 26.0; P = .030). Rates of MCID achievement were similar between groups for all PROs (HOS-ADL: BHD, 76.2% vs controls, 67.9%, P = .580; HOS-SS: BHD, 63.2% vs controls, 69.4%, P = .773; modified Harris Hip Score: BHD, 76.5% vs controls, 67.9%, P = .561; VAS pain: BHD, 75.0% vs controls, 91.7%, P = .110). Rates of PASS achievement were significantly lower in the BHD group for HOS-ADL (BHD, 39.1% vs controls, 77.4%; P = .002), HOS-SS (BHD, 45.5% vs controls, 84.7%; P = .001), and VAS pain (BHD, 50.0% vs controls, 78.5%; P = .015). No significant difference was found in the rate of subsequent reoperation on the index hip between groups. Kaplan-Meier survival analysis demonstrated comparable survivorship at long-term follow-up ( P = .645).Conclusion:After primary hip arthroscopy, patients with BHD in the setting of FAIS had significantly improved PRO scores at 10-year follow-up, comparable with propensity-matched controls without BHD. Rates of MCID achievement were similar between groups, although patients with BHD had lower rates of PASS achievement. Patients with BHD had similar long-term hip arthroscopy survivorship compared with controls, with no significant difference in rates of revision hip arthroscopy or conversion to total hip arthroplasty.

中文翻译：

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边缘性髋关节发育不良接受初次髋关节镜检查的患者的结果评分和生存率：一项至少 10 年随访的倾向匹配研究


背景：与没有发育不良的同等患者相比，患有交界性髋关节发育不良（BHD）并伴有股骨髋臼撞击综合征（FAIS）的患者在短期和中期随访中表现出相似的结果。然而，这些组之间的长期随访比较仍有待研究。目的：比较接受初次髋关节镜检查治疗 FAIS 的 BHD 患者与未接受 BHD 的匹配对照患者的长期临床结果。研究设计：队列研究;证据级别，2。方法：对 2012 年 1 月至 2013 年 2 月期间因 FAIS 接受髋关节镜检查的 BHD（外侧中心边缘角，18°-25°）患者进行回顾性队列研究。按年龄、性别和体重指数按 1:3 的比例对照接受初次髋关节镜检查的无 BHD 患者。比较各组患者术前和术后 10 年报告的结果 (PRO)，包括髋关节结果评分活动日常生活分量表 (HOS-ADL) 和运动分量表 (HOS-SS)、改良的 Harris 髋关节评分，12 -item 国际髋关节结果工具，疼痛和满意度视觉模拟量表 (VAS)。比较组间最小临床重要差异（MCID）和患者可接受症状状态（PASS）的达成率。评估各组之间的 Kaplan-Meier 生存曲线。 结果：平均随访 10.3 ± 0.3 年，28 名 BHD 患者（20 名女性；年龄 30.8 ± 10.8 岁）与 84 名接受初次髋关节镜检查的对照组相匹配。 10 年时，两组所有 PRO 指标均较术前评估显着改善（全部 P < .001）。除了 HOS-SS（BHD，62.9 ± 31.9 对比对照，80.1 ± 26.0； P = .030)。所有 PRO 组之间的 MCID 实现率相似（HOS-ADL：BHD，76.2% 对比对照组，67.9%，P = 0.580；HOS-SS：BHD，63.2% 对比对照组，69.4%，P = 0.773；改良 Harris 髋关节评分：BHD，76.5% 对比对照组，67.9%，P = 0.561；VAS 疼痛：BHD，75.0% 对比对照组，91.7%，P = 0.110）。 BHD 组 HOS-ADL 的 PASS 达成率显着较低（BHD，39.1% 对比对照组，77.4%；P = .002）、HOS-SS（BHD，45.5% 对比对照组，84.7%；P = .001） ）和 VAS 疼痛（BHD，50.0% 对比对照组，78.5%；P = .015）。各组之间的指数髋随后再次手术率没有显着差异。 Kaplan-Meier 生存分析表明，长期随访的生存率相当 ( P = .645)。结论：初次髋关节镜检查后，FAIS 背景下的 BHD 患者在 10 年随访中 PRO 评分显着提高，与没有 BHD 的倾向匹配对照相当。尽管 BHD 患者的 PASS 达成率较低，但各组之间的 MCID 达成率相似。与对照组相比，BHD 患者的髋关节镜手术长期存活率相似，但髋关节镜翻修率或转为全髋关节置换术的比率没有显着差异。