Borderline Dysplastic Female Patients With Painful Internal Snapping Improve Clinical Outcomes At Minimum 2-Year Follow-Up Following Hip Arthroscopy With Femoroplasty, Labral Repair, Iliopsoas Fractional Lengthening, and Capsular Plication: A Propensity-Matched Controlled Comparison
Authors: Maldonado DR, Diulus SC, Annin S, Shapira J, Rosinsky PJ, Kyin C, Lall AC, Domb BG
DOI: 10.1016/j.arthro.2021.03.034
Background
Women with borderline hip dysplasia often experience painful internal snapping and poor outcomes if untreated. This study evaluates a combined surgical approach (femoroplasty, labral repair, iliopsoas fractional lengthening, and capsular plication—FLIP) for this group.
Methods
74 hips in women with borderline dysplasia and internal snapping were treated with FLIP and compared to matched controls without snapping to assess clinical outcomes over at least 2 years.
Key Findings
- Significant improvements in pain and all patient-reported outcomes were observed.
- The FLIP group achieved similar clinical improvements to controls without internal snapping.
- High rates of achieving meaningful clinical improvement (MCID) were reported.
Conclusions
The FLIP procedure effectively improves pain and hip function in borderline dysplastic women with painful internal snapping, with results comparable to patients without snapping symptoms.
What Does This Mean for Providers
- Consider the FLIP procedure as a comprehensive surgical approach for female patients with borderline dysplasia and symptomatic internal snapping.
- Expect favorable mid-term outcomes comparable to patients without snapping.
- Use propensity-matched data to counsel patients realistically about expected improvements.
- Monitor outcomes closely to continue refining patient selection and surgical technique.