Painful Borderline Acetabular Dysplasia: What's New?

Abstract

Developmental dysplasia of the hip (DDH) is a complex static-dynamic condition resulting in chronic joint instability and osteoarthritis. Borderline acetabular dysplasia refers to slightly abnormal patterns in the acetabular shape and coverage that are not within the dysplastic range. However, they can predispose to mechanical dysfunction and hip instability. Diagnosis and treatment remain controversial topics in hip preservation, with little current comparative literature to guide accurate diagnosis and treatment decision-making. Historically, the diagnosis of borderline DDH relied on assessments of the acetabular anatomy on anteroposterior pelvic radiography, most commonly the lateral central-edge angle (LCEA), with normal values ranging from 20 to 25° or, in some more recent studies, 18 to 25°. Surgical treatment decision-making debates the use of isolated hip arthroscopy or periacetabular osteotomy, considering the difficulty in determining a fundamental mechanical diagnosis (instability versus femoroacetabular impingement) in subjects with borderline DDH. Therefore, for effective surgical decision-making, the evaluation of additional bone anatomy characteristics, instability, and patients' features is essential.

Keywords

decision making - diagnostic imaging - femoracetabular impingement - hip dislocation - hip joint

Financial Support

The authors declare that they did not received financial support from agencies in the public, private or non-profit sectors to conduct the present study.

Publication History

Received: 19 September 2023

Accepted: 23 June 2024

Article published online:
02 April 2025

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