2024 AANA/ISAKOS Specialty Day All-Access Pass-Case Panel Discussion: FAI and Hip Dysplasia

Video Transcription

Video Summary

A panel of experts discussed complex hip cases, focusing on young athletes and adults with femoroacetabular impingement (FAI) and hip arthritis. They debated surgical options, including hip arthroscopy, labral reconstruction, femoral osteotomy, and hip replacement. For a 19-year-old athlete with significant hip damage, they favored arthroscopy with caution, emphasizing that surgery may only temporarily relieve symptoms and delay progression. They stressed the importance of individualized patient-centered decisions integrating evidence, expectations, and surgical expertise. Imaging techniques, especially 3D CT and MRI, are critical for assessing femoral version and bony morphology, but consensus on measurement methods is lacking. Femoral retroversion influences outcomes, and osteotomy is considered when rotation abnormalities are severe. For older patients, surgery decisions depend on activity levels and joint space. Overall, the panel highlighted the complexity of balancing joint preservation with realistic outcomes, advocating for standardized imaging practices and shared decision-making tailored to patient goals.

Asset Caption

Vikas Khanduja, F.R.S.C. (Tr & Orth), Christopher M. Larson, M.D., Olufemi R. Ayeni, M.D., Ph.D., M.Sc., F. Winston Gwathmey, Jr., M.D., Sharon L. Hame, M.D., Andrea M. Spiker, M.D., Marc R. Safran, M.D., Ph.D.

Keywords

femoroacetabular impingement

hip arthroscopy

labral reconstruction

femoral osteotomy

hip arthritis

3D CT and MRI imaging