2023 Annual Meeting Hip Access Pass *Non-CME*-When Is Arthroscopy Not Enough? My Indications for PAO

Video Transcription

Video Summary

Dr. Andrea Spiker from the University of Wisconsin discusses the indications for periacetabular osteotomy (PAO). The classic indication for PAO is hip dysplasia, diagnosed by a lateral center edge angle measurement of less than 25 degrees. Other radiographic findings can also suggest hip dysplasia. Dysplasia is a radiographic diagnosis, while instability is a clinical diagnosis. In cases of borderline hip dysplasia or normal lateral center edge angle, a PAO may still be appropriate if there is an indication of clinical hip instability. The PAO surgery is performed through multiple osteotomies, allowing for the rotation of the acetabular fragment. Adding a hip arthroscopy to a PAO is controversial but may be performed if there is intraarticular pathology. PAO has good long-term outcomes, with high survival rates and low complication rates. Postoperative recovery is similar to hip arthroscopy, with slightly longer weight-bearing restrictions. PAO can reverse the natural history of hip dysplasia and prevent osteoarthritis.

Asset Caption

Andrea M. Spiker, M.D.

Keywords

periacetabular osteotomy

indications

hip dysplasia

lateral center edge angle

clinical hip instability