• Dr. Domb!

    Thanks a lot for getting my hip right. Looking forward to a full recovery and a great season. Thanks again for everything.

    Corey WoottonChicago Bears and Detroit Lions
  • Thank you for all that you have done for me and the team. My hip feels so much better, and because of you I'm pain free.
    Sylvia Fowles WNBA Finals MVP, 2-time Olympic Gold Medalist
  • Thank you for working your magic! You're the best!
    Zakiya BywatersChicago Red Stars, National Women's Soccer League
  • Thanks for all the love and positive Energy that was put into my surgery. May the Lord bless you and your family.
    Atari BigbyGreen Bay Packers and San Diego Chargers
  • Dr. Domb, Thanks for fixing me up
    Rashied DavisChicago Bears
  • Huge thank you to Dr. Domb for always taking care of me and getting me back on the court in no time!
    Elena Delle DonneChicago Sky, MVP of the WNBA
  • Dr. Domb! Thanks for taking care of the hip! All the best to you and your staff
    Roosevelt ColvinChicago Bears' All-Decade Defense team
  • Thanks doc for fixing my hip!
    Ryan ChiaveriniWindy City Live Co-Host on ABC7

2013- Domb et al. Arthroscopic Capsular Plication and Labral Preservation in Borderline Hip Dysplasia: Two-Year Clinical Outcomes of a Surgical Approach to a Challenge Problem. American Journal of Sports Medicine

Background: The role of hip arthroscopy in the treatment of patients with dysplasia is unclear because of the spectrum of dysplasia that exists. Patients with borderline dysplasia are generally not candidates for periacetabular osteotomy because of the invasive nature of the procedure. However, arthroscopy in dysplasia has had mixed results and has the potential to exacerbate instability.

Hypothesis: Patients with borderline dysplasia will demonstrate postoperative improvement, high satisfaction rates, and low reoperation rates after a surgical approach that includes arthroscopic labral repair augmented by capsular plication with inferior shift.

Study Design: Case series; Level of evidence, 4.

Methods: Between April 2008 and November 2010, patients less than 40 years old who underwent hip arthroscopy for symptomatic intra-articular hip disorders, with a lateral center-edge (CE) angle 18 and 25, were included in this study. Patients withTo¨ nnis grade 2 or greater, severe hip dysplasia (CE 17), and Legg-Calve-Perthes disease were excluded. Patient-reported outcome scores, including the modified Harris Hip Score (mHHS), Non-Arthritic Hip Score (NAHS), Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Hip Outcome Score-Activity of Daily Living (HOS-ADL), and visual analog scale (VAS) for pain were obtained in all patients preoperatively and at 1, 2, and 3 years postoperatively. Revision surgery and complications were recorded for each group.

Results: A total of 26 patients met the criteria to be included in the study. Of these, 22 (85%) patients were available for follow-up. The mean (6 standard deviation) length of follow-up for this cohort was 27.5 6 5.5 months (range, 17-39 months) and the average age was 20 years (range, 14-39 years). The mean lateral CE angle was 22.2 (range, 18-25) and the mean To¨ nnis angle was 5.8 (range, 0-17). There was significant improvement in all patient-reported outcome scores (mHHS, NAHS, HOS-SSS, and HOS-ADL) (P\.0001). There was a significant improvement in VAS scores from 5.8 to 2.9 (P\.0001). Overall patient satisfaction was 8.4 out of 10. Seventeen patients had good/excellent results (77%). Two patients required revision arthroscopy.

Conclusion: Patients with borderline dysplasia have often fallen into a gray area between arthroscopy and periacetabular osteotomy, and viable treatment options have remained scarce. The current study demonstrates favorable results at 2-year follow-up for an arthroscopic approach that includes labral repair augmented by capsular plication with inferior shift.

Keywords: hip; arthroscopy; dysplasia; capsular plication

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