2025 AANA/ASES Specialty Day All-Access Pass-AANA Session IV: Hip Cases

Video Transcription

Video Summary

The panel discusses management options for a 35-year-old female with borderline hip dysplasia, early cartilage wear, labral tear, and FAI, debating arthroscopic treatment, periacetabular osteotomy (PAO), and total hip arthroplasty (THA). Dr. Larson supports hip arthroscopy, highlighting improved long-term outcomes with careful patient selection and surgical technique, noting it carries fewer complications than PAO and delays need for arthroplasty. Dr. Poon advocates for PAO, emphasizing its ability to correct abnormal hip mechanics in dysplasia and potentially alter arthritis progression, though it involves a bigger surgery and longer recovery. Dr. Dohm argues for THA as the definitive operation but acknowledges its complexity and increased risks following previous surgeries. The panel agrees decisions hinge on patient age, activity level, cartilage status, and expectations. For borderline cases like this, shared decision-making incorporating imaging and patient goals is essential. Ultimately, arthroscopy can be effective for select patients, but PAO or THA may be preferred when instability or arthritis advance.

Asset Caption

Moderators: Mia S. Hagen, M.D., Robert W. Westermann, M.D.
Faculty: Christopher M. Larson, M.D., Stephanie Pun, M.D., Benjamin G. Domb, M.D.

Keywords

borderline hip dysplasia

hip arthroscopy

periacetabular osteotomy

total hip arthroplasty

labral tear

femoroacetabular impingement