EP1.78 Evolution of Arthroscopic Management for Borderline Hip Dysplasia: a 10-year Single-Surgeon Comparison of Radiographic Correction and Two-Year Patient Reported Outcomes

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ID: 331280
2026
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Abstract
Abstract Background Contemporary hip arthroscopy techniques for borderline dysplasia continue to evolve, but it is unclear whether radiographic correction and 2-year patient-reported outcomes (PROs) have improved across eras. Purpose To compare radiographic correction and 2-year PROs between a historical (10-year) and recent (2-year) single-surgeon borderline dysplasia cohort, including FEAR index and acetabular/femoral correction metrics. Methods A retrospective single-surgeon cohort with 2-year follow-up was analyzed (10-year, n = 29; recent 2-year, n = 28). Inter-reader reliability was assessed with ICC. Baseline balance was evaluated using standardized mean differences (SMDs). Given small sample size and baseline imbalance, unadjusted between-group continuous comparisons used Mann-Whitney U tests. Outcomes included mHHS and NAHS (absolute 2-year scores and change from baseline), plus alpha angle, FEAR index, and ACEA preoperative, postoperative, and change values. Adjusted linear models controlled for baseline PRO, age, sex, and BMI. Direct era-comparison interaction models tested whether covariate-outcome relationships differed by era. Results Reliability was moderate to excellent across most measures (eg, ACEA ICC(2,k) = 0.992 pre and 0.973 post; LCEA ICC(2,k) = 0.820 pre and 0.923 post). Baseline imbalance was present (notably baseline PROs and TONNIS). Unadjusted improvement favored the historical cohort: ΔmHHS 34.7 vs 20.7 (p = 0.004) and ΔNAHS 37.8 vs 22.1 (p<0.001). Absolute 2-year mHHS was higher in the recent cohort (92.3 vs 86.8; p = 0.029), while absolute 2-year NAHS was not significantly different (p = 0.089). In adjusted models for 2-year outcomes, era was not an independent predictor (mHHS: β=+2.34 for 10Y vs recent, p = 0.575; NAHS: β=+5.93, p = 0.197), whereas baseline PRO remained significant. Radiographic change did not differ by era (Δalpha angle p = 0.643; ΔFEAR p = 0.831; ΔACEA p = 0.994). Era interaction terms were not significant for mHHS or NAHS models (all p>0.05). Spearman analyses showed no significant associations between radiographic change (ΔFEAR/ΔACEA/Δalpha angle) and PRO improvement in either cohort. Conclusion In this single-surgeon borderline dysplasia series, contemporary and historical cohorts had similar radiographic correction magnitude and no adjusted era-dependent difference in 2-year PROs. Apparent unadjusted differences in improvement were not sustained after accounting for baseline status and demographics.
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Authors Jade Refuerzo, Sangmin Lee, Samy Shelbaya, Zachary Taylor, Nathaniel P. Mercer, Thomas J. Youm
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.262
URL
https://doi.org/10.1093/jhps/hnag043.262
Keywords Keywords not found

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