Scope Essentials 2024-When Hip Arthroscopy is Not Enough

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

Video Transcription

Video Summary

Dr. Andrea Spiker discusses when hip arthroscopy is insufficient and open surgery is needed. Open surgery is clearly indicated in cases of frank hip dysplasia, Perthes disease sequelae, severe femoral version abnormalities, or when arthritis is advanced. Periacetabular osteotomy (PAO) offers powerful correction for dysplasia, including borderline cases, but requires careful patient selection. Borderline dysplasia—with lateral center edge angle between 18-25°—often involves labral pathology; outcomes depend on preserving labral and capsular tissues during arthroscopy. Surgical hip dislocation remains useful for severe deformities or osteochondral defects. Clinical instability and precise radiographic evaluation guide treatment choice to avoid failed arthroscopy and rapid arthritis progression.

Asset Caption

Andrea Spiker, M.D.

Keywords

hip arthroscopy

open hip surgery

hip dysplasia

periacetabular osteotomy

surgical hip dislocation