The Failed Hip Arthroscopy - How to Successfully Manage (and Not Replace) It (AANA22)-Open Management of Bony Issues

Video Transcription

Video Summary

The speaker discusses indications for open hip preservation surgery following failed hip arthroscopy, emphasizing when open surgery is clearly preferred versus when choices are less obvious. Open surgery is clearly indicated in frank hip dysplasia (LCEA <18°), Perthes disease sequelae, severe arthritis, and large osteochondral defects. Borderline hip dysplasia (LCEA 18-25°) often presents a gray zone; while hip arthroscopy can work if labral and capsular repair is done by experts, failure is common without it, and PAO shows excellent long-term outcomes even in minimal dysplasia. Proper radiographic evaluation including lateral center edge angle and tonus angle measurements and clinical tests for instability are essential to avoid misdiagnosis and failed arthroscopy. Femoral version abnormalities may require femoral derotational osteotomy when other treatments fail. Surgical hip dislocation remains useful for severe deformities or large lesions. Total hip replacement is reserved for advanced arthritis. The talk underscores comprehensive evaluation to select appropriate surgical strategies in hip preservation.

Asset Caption

Andrea M. Spiker, M.D.

Keywords

open hip preservation surgery

hip arthroscopy failure

hip dysplasia indications

radiographic evaluation hip

femoral derotational osteotomy