2023 Specialty Day Access Pass-Borderline Dysplasia: Scope or PAO?

Video Transcription

Video Summary

The panel discusses two cases of borderline hip dysplasia, emphasizing the complexity of diagnosis and treatment. The first case, a 39-year-old woman with bilateral hip pain and prior spinal fusion, shows dysplastic features and mixed morphology including a CAM lesion, complicating treatment decisions. They consider arthroscopy, periacetabular osteotomy (PAO), or combined approaches, noting arthroscopy alone risks failure due to instability and cartilage damage. Imaging strategies include plain MRI, MR arthrogram, and 3D CT to assess cartilage, labral pathology, and acetabular coverage. Capsular management and cautious CAM resection are stressed to avoid further joint instability. The patient initially had arthroscopy but later required PAO after symptom progression. The second case involves a 17-year-old with borderline dysplasia and groin pain, managed initially with arthroscopy, with PAO as a possible next step if symptoms worsen. The panel highlights the importance of individualized care, detailed imaging, and careful patient counseling regarding long-term commitments and outcomes.

Asset Caption

Moderators: Shane J. Nho, M.D., M.S., Sharon L. Hame, M.D.
Panel: Stephanie J. Swensen Buza, M.D., Michael J. Salata, M.D., Bryan T. Kelly, M.D., Jeffrrey J. Nepple, M.D., Allston J. Stubbs IV, M.D., M.B.A.

Keywords

borderline hip dysplasia

arthroscopy

periacetabular osteotomy

CAM lesion

imaging techniques