2024 AANA/ISAKOS Specialty Day All-Access Pass-Debate Introduction: 26-Year-Old Female With Borderline Dysplasia (DDH) and No Significant Arthritic Change

Video Transcription

And we'll thank the committee for having a nice lunch and a great innovation session to potentially stop the room from completely clearing out.  So, great for you guys sticking around. So, we're gonna start off here with the first debate. And so, we'll have that first, the first slides.  We can have both of our debaters come up if you guys wanna sit down. So, if we can bring up the first PowerPoint. Oh, just click.  Okay, so this is gonna be our first debate. So, what we have here is a 26-year-old female, a one-year history of right anterior hip flexion base pain. She's also a ballet dancer.  Pain with prolonged walking, torsional high-range motion dance activities. She's failed physical therapy, she's had an injection. The injection gave her good short-term relief,  but no long-term relief, and she does have some pain in her hip. She does have some short-term relief, and she does have some anterior snapping as well.  Range of motion, she has 15 degrees internal rotation inflection, 30 internal rotation prone, 70 degrees of external rotation. Her impingement tests are positive.  She has some pain with passive straight hip flexion as well, and mildly painful internal snapping, and then based on Baten's criteria, she's also significantly hypermobile.  She does not have any pain with anterior apprehension testing or apprehension, and she has a negative issue femoral impingement test. So these are the imaging studies.  Sorry, I don't have an AP of both hips on here. We didn't have a lot of room, but she has a lateral center edge angle of 23 degrees. Her inclination or tonus angle is nine.  Her fear index is fairly neutral. She has an elevated alpha angle slightly. A type two, slightly prominent anterior inferior iliac spine  with some apparent retroversion on the plane radiographs. MRI shows no chondral pathology, some cystic labral degeneration, and three-dimensional CT scan shows  that her femoral version is 12 degrees, and she has a type two AIIS. So to start off the debate, we're gonna have Dr. Al Stubbs,  who's coming by way of Winston-Salem, North Carolina, and he's gonna debate that we should do an all arthroscopic approach.

Video Summary

The video transcript discusses a case of a 26-year-old female ballet dancer with hip pain and limited range of motion. Despite failed physical therapy and a temporary injection relief, she still experiences discomfort. The patient exhibits impingement signs and is hypermobile. Imaging studies reveal anatomical variations and labral degeneration. The debate topic is whether an all arthroscopic approach should be pursued for treatment. Dr. Al Stubbs from Winston-Salem, North Carolina, advocates for this approach. This summary highlights the patient's history, examination findings, imaging results, and the proposed treatment debate on managing her hip condition.

Asset Caption

Christopher M. Larson, M.D.

Keywords

ballet dancer

hip pain

limited range of motion

arthroscopic approach

labral degeneration