Hip osteoarthritis in young patients, particularly when related to developmental dysplasia of the hip or cam-type femoroacetabular impingement, poses complex therapeutic challenges, and while isolated arthroscopic treatments show promising outcomes in borderline cases, the effectiveness of combining arthroscopic shelf acetabuloplasty with femoroplasty and labral repair remains insufficiently documented. Therefore we performed a retrospective investigation aiming to evaluate the functional outcomes of combined treatment using arthroscopic shelf acetabuloplasty based on the Chiron et al. technique and cam-type femoroacetabular impingement correction for patients with mild and borderline hip dysplasia.

After a mid term follow up combined surgery led to a satisfactory improvement in clinical and radiological parameters.

This retrospective study involved a continuous cohort of 13 patients undergoing combined surgery for arthroscopic shelf acetabuloplasty and cam-type femoracetabular impingement correction at a minimum of twenty-two months follow up. Clinical and radiographic assessments were made pre- and post-operatively, including validated tools such as the femoral epiphyseal acetabular roof index, Tönnis grading, Cliff sign and iHot-12 scores for functional outcomes. The intraoperative findings were also reported, as well as complications and reoperation.

At a mean follow-up of 27.2 ± 3.7 months (range, 22−34 months), there was a trend toward improvement in iHOT-12 scores, which did not reach statistical significance (mean Δ +27.2/100 (p = 0.084)), and overall patient satisfaction was favorable (6.9 ± 2.9 out of 10). The lateral center-edge angle increased significantly from 17.4 ± 3.4 ° (range, 14–25) to 39.9 ± 3.8 ° (range, 32–45), while the alpha angle decreased significantly from 61.4 ± 10.0 ° (range, 44–78) to 43.0 ± 6.5 ° (range, 34–54). Postoperative complications included one nonunion (7.7%), partial shelf lysis / remodeling in 6 of the 13 patients (46.2%) of patients and hardware discomfort necessitating removal in 12 of the 13 patients (92.3 %).

The preliminary findings of this study indicate that the combined approach of arthroscopic shelf acetabuloplasty with cam-type femoroacetabular impingement correction is a promising treatment option for patients with mild and borderline hip dysplasia with concomitant cam-type femoroacetabular impingement. This approach can lead to improvements in functional scores, normalised radiographic parameters, and acceptable patient satisfaction. Nonetheless, there was a high rate of complications and reoperations, mostly due to hardware-related discomfort.

IV; Retrospective cohort study