So next we'll have Dr. Moran. He's coming from Madrid, Spain. And he's going to argue to go straight to periastabular osteotomy. Thank you so much, all. Thank you for your presentation. I agree completely with everything you present here. But these are my disclosure. I have some concern about that. So I have to say that you have to go with the PO, of course. Because try to imagine this kind of patient. We are talking about 26-year-old lady. That daily practice could be like that. So try to imagine what kind of patient are we treating. We are not treating x-rays or MRIs with the labrum. We are treating patients. So this is the case. And this is the case where we can see in the 3D reconstruction, there is a deficiency of the bone over there. So there is a problem of the structural bone or the acetabulum there. And we need to fix that. But also, we have another bone deformities there that we have to take into account. So the problem comes from here. I mean, the labrum is damaged because of this position of the acetabulum. And we are going to fix the labrum. That's correct. No problem with that. But if you don't fix this acetabular bone, this bone deficiency, you will continue with the problem in this kind of patient that are 26, could be your daughter. What do you do for your daughter? OK. And I propose this surgery. It had been described by Rainer Ganz many years ago. And this is a correction of the bone. You cut the bone in different positions. You cut the pubis. You cut the ischium. You cut the ilium. And you relocate this bone deformity, this bone deficiency in this very young patient that need this hip for more than 30 years. And this is a situation that we can solve. So when we were in the surgery, we can correct this deficiency, bone deficiency, in any of the 3D planes of the space. And you can check. This is a cadaveric study. You can correct the deformity in any plane. You can choose where is the deformity and how to correct that. I'm trying to keep this hip safe for the next 50 years in your daughter that is 26. So that's my proposal for this case. And we are treating the cause. We're not treating the effect. That's important, that case. And there is a lot of literature that support this arthroscopy treatment. Dr. Al mentioned that. But be very careful, because there are another publication about some failures in the long term with this only arthroscopy approach for this PEO, this dysplasia. So the conversion rate in this patient sometimes is a little bit high. So be very careful. And we analyze the outcomes. We are analyzing, like in this paper, the minimal clinical important difference. And maybe this lady that is 26 needs more demanding of this hip in the future. So my proposal is to do maybe this surgery, this correction of the labrum, but always should be with a correction of the bone deformity. That's my proposal. So in the long term, what have we seen in the publication with the PEO? We have seen that one degree of not correction of this hip can lead to osteoarthritis and a total hip replacement very soon. And this has been published in many articles, very long term articles with the X-rays and the progression of the osteoarthritis. This is from Europe, from Netherlands. And there are many, many articles in the long term with the X-rays that the progression of the degeneration of the joint with this uncovered acetabulum is demonstrated. So be very careful. And we do this surgery. This is a fantastic study from the Bern Group in Switzerland with 30-year follow-up after periacetabular osteotomy, after the correction of the problem. And the results are so good in this kind of patient, and especially in young patients, then it's zero-two with function. So my recommendation as a conclusion is that patients should be advised about this natural progression. And we have to treat the cause and not only the effects. Thank you so much.

hip issues

periastabular osteotomy

bone deficiencies

uncorrected hip abnormalities

surgical correction