Borderline Hip Dysplasia (AANA25)-Borderline Hip Dysplasia: Hip Arthroscopy vs. Periacetabular Osteotomy

Video Transcription

Video Summary

The conference, "ICL 101, Borderline Hip Dysplasia: Hip Arthroscopy versus Periacetabular Osteotomy (PAO)," opened with discussions on defining borderline hip dysplasia, primarily evaluated using the lateral center edge angle (LCEA), ranging between 20°-25°. Dr. Matthew Kraler stressed that hip dysplasia does not equate to hip instability. Factors like hypermobility, demographics, clinical exam findings, and advanced imaging are crucial in deciding treatment paths, be it hip arthroscopy, PAO, or a combined approach.<br /><br />Dr. Derek Ochiai emphasized the need for thorough physical examinations, highlighting tests like the Baten test for hypermobility and several instability assessments. These tests help differentiate between instability and impingement, crucial for tailoring patient treatments.<br /><br />The panel moved to varying opinions regarding appropriate treatments. Dr. Ochiai argued for exclusive hip arthroscopy based on certain patient criteria, while Dr. Ernie Sink defended PAO as the gold standard for treating dysplasia, aiming not just for pain relief but altering natural history to avoid osteoarthritis.<br /><br />Dr. Kraler favored a combined approach in certain patients, advocating for staged procedures—hip arthroscopy followed by PAO. This method, although intense, potentially offers comprehensive joint preservation by addressing multiple pathologies simultaneously.<br /><br />Throughout the session, procedural nuances like the importance of femoral version considerations and the role of technologies like RadLink for precise surgical outcomes were discussed. The consensus was that personalized treatment approaches based on comprehensive patient evaluations lead to optimal outcomes in managing borderline hip dysplasia.

Asset Caption

Matthew J. Kraeutler, M.D. | Ernest L. Sink, M.D. | Shane J. Nho, M.D., M.S. | Thomas H. Wuerz, M.D. | Omer Y. Mei-Dan, M.D.

Keywords

borderline hip dysplasia

hip arthroscopy

periacetabular osteotomy

lateral center edge angle

hip instability

hypermobility

patient treatment

femoral version

RadLink technology

joint preservation