AOSSM 2022 Annual Meeting Recordings - no CME-Borderline Dysplasia: What Is It and What Factors Guide Treatment?

Borderline Dysplasia: What Is It and What Factors Guide Treatment?

Video Transcription

Video Summary

In this video, the speaker discusses the controversy surrounding borderline dysplasia in hip preservation. While there is consensus on the need for a periacetabular osteotomy (PAO) in truly dysplastic hips, borderline dysplasia presents a challenge in determining the appropriate treatment. Borderline dysplasia is not a singular hip morphology but rather a variable one, with varying degrees of anterior, lateral, and posterior coverage. Studies have shown that the risk of osteoarthritis extends into the borderline range. The speaker emphasizes the importance of a comprehensive evaluation, including history, physical exam, and imaging, to guide treatment decisions. The literature on treatment options, such as isolated hip arthroscopy or PAO combined with arthroscopy, is somewhat weak, lacking comparative evidence. However, PAO has shown good outcomes in well-selected cases. The speaker also introduces a borderline hip instability score as a potential tool for decision-making in the future. Overall, the goal is to determine the patient's position on the continuum between instability and impingement, considering factors such as deformity characteristics, patient characteristics, and range of motion.

Asset Caption

Jeffrey Nepple, MD, MS

Keywords

borderline dysplasia

hip preservation

periacetabular osteotomy

comprehensive evaluation

treatment options