APEX Hip Enhancing Clinical Expertise and Proficiency (November 2023)-When Hip Arthroscopy is Not Enough: When to Consider Open Surgery

When Hip Arthroscopy is Not Enough: When to Consider Open Surgery

Video Transcription

Video Summary

In this 2023 lecture on hip preservation, the speaker discusses when open hip surgery, such as periacetabular osteotomy (PAO), surgical hip dislocation, or femoral derotational osteotomy, is preferable over hip arthroscopy. Clear indications for open surgery include frank hip dysplasia (lateral center edge angle <18°), sequelae of Perthes disease, and advanced arthritis where total hip replacement is better. Borderline dysplasia (center edge angle 18-25°) requires careful evaluation—hip arthroscopy can succeed if soft tissues are preserved and repaired, but PAO may be necessary. Femoral version abnormalities and complex deformities may also warrant open procedures. Proper patient selection is critical to avoid failed arthroscopy and early osteoarthritis.

Asset Caption

Andrea M. Spiker, M.D.

Keywords

hip preservation

open hip surgery

periacetabular osteotomy

hip arthroscopy

hip dysplasia