So, I think that just reflects that the meeting is actually being held in North America and North Europe. If you actually did this meeting in Europe and put this question, I'm sure you'll see the reverse answer. You'll do more POs than hip arthroscopies. Okay, so that was a fairly docile and a very measured debate, and I hope the next one is a bit better. So, let's invite Femi Ayeni and Ben Dom on stage, and hopefully they'll give it a good fight on this case. Welcome, gents. So, Ben from the American Hip Institute in Chicago, and Femi from the home of evidence-based medicine McMaster, both Canadians, and we'll have some fun now. Okay, so 34-year-old wine merchant, and during the weekends he's a climbing instructor as well. Painful left hip over a year, worse in activities which require deflection and rotation, pain constant affecting his activities of daily living, and he rates it as about six on ten on the verbal analog scale, mechanical symptoms of clicking and locking, past medical history not significant, and no known drug allergies. Clinical examination fairly standard, gauged normal, Trendelenburg's negative, flexion up to 90, restricted, internal rotation and nitroglycerin flexion restricted to 10, and external rotation, again, restricted to 40, impingement and Faber positive, Logroll negative. These are his plain radiographs. You're looking at the left hip, reasonably well-preserved joint space. You can see the beginnings of a cyst on the acetabulum, and probably sublaterally you've got some reduction of joint space there on the AP. These are the MRI scans which show you the acetabular labral pathology, that cyst developing in the acetabulum, and that's some articular cartilage degeneration on the inferior aspect as well along with the labral tear. The CT scan along with 3D reconstruction, got CAM morphology, a bit of anterior inferior islet spine morphology there as well, probably two, reduction of the posterior joint space on that view, femoral version of 12, and acetabular version of 28 degrees. So Ben wants to scope these patients and do an osteochondroplasty, and he thinks that's the best thing for these patients. Ben.

hip pain

acetabular labral pathology

articular cartilage degeneration

impingement tests

hip arthroscopy