Surgical hip dislocation is more powerful than arthroscopy for the treatment of pronounced acetabular overcoverage

Objectives: With the development of hip arthroscopy (HA), a shift away from surgical hip dislocation (SHD) is becoming a noticeable reality. It was the aim of this study to examine whether SHD provides a benefit over HA regarding its corrective power in the treatment of femoroacetabular impingement (FAI).

It was hypothesized that SHD provides the more powerful tool for acetabular correction in FAI surgery compared to HA.

Methods: The examined cohort consisted of 85 hips of which 31 (36%) underwent a high degree of acetabular correction which was defined as a correction of >2 standard deviations from the population mean. A lateral center edge angle (LCE) correction>12° or an acetabular index (AI) correction>8° were therefore considered to high correction. A logistic regression model was applied to determine factors influencing high correction in FAI surgery. Subsequent adjustment was performed using a multivariate model.

Results and Conclusion: SHD showed more likelihood of successful acetabular correction in patients with pronounced acetablar coverage (odds ratio (OR) 10.0 confidence interval (C.I) 2.3 to 44.0, p = 0.002). This was not found to be the case for femoral correction (p>0.05).

It may be concluded that surgical hip dislocation is a powerful modality for achieving high degrees of acetabular correction in the situation of a femoroactabular conflict, being defined as an LCE correction of>12° or AI correction of>8°. The reason for these results may be seen in the excellent exposure and the improved possibility of performing dynamic intra-operative examination to verify the results. The benefits are only limited to large acetabular correction. These findings should provide a helpful tool for decision making in clinical practise.

Stichwörter: Surgical hip dislocation; hip arthroscopy

Publication History

Article published online:
15 October 2020