Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice (2021 Annual Meeting)-Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice-Salata

Hip Arthroscopy - My Worst Day in the Operating Room in 2020: What Happened and How it Changed My Practice-Salata

Video Transcription

Video Summary

The speaker discusses challenges in treating borderline hip dysplasia and femoroacetabular impingement (FAI), highlighting a 16-year-old gymnast with hip pain unresponsive to conservative care. Traditional measurements like center edge angle, acetabular inclination (Tönnis angle), extrusion index, and the "FEAR" index are used to assess hip stability and guide treatment decisions between arthroscopy (scoping) and periacetabular osteotomy (PAO). The patient initially had arthroscopic treatment with labral repair and capsular plication, improving for two years but ultimately requiring PAO for lasting relief and return to full activities. The speaker emphasizes that borderline hips often present diagnostic and treatment dilemmas, with instability playing a key role. Over-resection of the acetabular rim and inadequate attention to capsular integrity can worsen outcomes. They advocate for individualized evaluation considering morphology, ligamentous laxity, and dynamic examination, noting the evolving understanding of hip instability in surgical decision-making to improve patient function and avoid failures.

Asset Caption

Dr. Michael Salata

Keywords

borderline hip dysplasia

femoroacetabular impingement

arthroscopy

periacetabular osteotomy

hip instability