Summary

Hips with acetabular overcoverage and coxa profunda demonstrated favorable outcomes after primary hip arthroscopy at five-year minimum follow-up.

Abstract

Purpose

To report minimum five-year outcomes of primary hip arthroscopy in hips with acetabular overcoverage and coxa profunda and compare their results to a matched control group with normal acetabular coverage.

Methods

Data was collected between February 2008 and January 2019 and reviewed for all patients who underwent primary hip arthroscopy. Patients were excluded if they had previous ipsilateral hip pathology and Tonnis grade > 1. Patients were placed in the acetabular overcovered cohort if they had LCEA > 40° and radiographically identified coxa profunda with ilioischial line lateral to the acetabular floor. Patients with LCEA from 25 to 39.99° were placed in the normal acetabular coverage cohort. Overcovered hips were matched to normal covered hips in a 1:1 ratio based on age, sex, BMI, Acetabular Outerbridge Grade, capsular and labral treatment. Patient characteristics, radiographic measurements, intraoperative findings, surgical procedures, and patient-reported outcomes (PROs) were compared. Rates of meeting clinically relevant thresholds, secondary hip procedures, and complications were compared.

Results

A total of 110 hips were included in the study, with 55 hips per group. The groups had comparable demographics, intraoperative findings, and labral procedures. Acetabuloplasty was performed more in the overcovered cohort (p < 0.05). Both cohorts showed significant improvement in all PROs. In all PROs, both cohorts had similar preoperative and postoperative scores (p > 0.05). Rates of meeting clinical meaningful thresholds, undergoing subsequent hip surgeries, and complications were similar between the two cohorts (p > 0.05).

Conclusion

Hips with acetabular overcoverage and coxa profunda demonstrated favorable outcomes after primary hip arthroscopy at five-year minimum follow-up. When compared with a propensity matched control group with normal acetabular overcoverage, similar improvement in all PROs were reported. Furthermore, rates of achieving clinically meaningful undergoing subsequent hip surgery, and complications were similar between the two cohorts.