Editorial Commentary: Evaluate for the Beighton Score and Additional Radiographic Signs of Instability Prior to Proceeding With Hip Arthroscopy in Patients With Combined Borderline Hip Dysplasia and Excessive Femoral Anteversion

Editorial Commentary: Evaluate for the Beighton Score and Additional Radiographic Signs of Instability Prior to Proceeding With Hip Arthroscopy in Patients With Combined Borderline Hip Dysplasia and Excessive Femoral Anteversion

Authors

Curley AJ, Domb BG

Journal

Arthroscopy, April 2023

Objective

To discuss the importance of evaluating the Beighton Score and other radiographic signs of instability before performing hip arthroscopy in patients with combined borderline hip dysplasia (BHD) and excessive femoral anteversion (EFA).

Key Findings

• EFA, defined as an angle greater than 20°, can lead to hip instability, which may be worse when combined with BHD.
• When treating these patients, it’s essential to distinguish between symptoms of femoroacetabular impingement (FAI) and hip instability.
• Radiographic signs such as the Tönnis angle, coxa valga, and acetabular coverage should also be evaluated for accurate diagnosis.
• Isolated arthroscopy may not be effective, and more comprehensive treatments, like periacetabular osteotomy, may be necessary.

Conclusion

Patients with EFA and BHD may require a thorough evaluation for instability before considering hip arthroscopy. Additional imaging and clinical tests can help guide the treatment choice to avoid suboptimal outcomes.

What Does This Mean For Patients

If you have borderline hip dysplasia and excessive femoral anteversion, make sure your surgeon checks for other instability factors before proceeding with hip arthroscopy. This can help ensure the best possible outcome for your surgery.