IC 108-2023: The Failed Hip Arthroscopy - How To Successfully Manage (and Not Replace) It-IC 108 - The Failed Hip Arthroscopy - How To Successfully Manage (and Not Replace) It (4/5)

IC 108 - The Failed Hip Arthroscopy - How To Successfully Manage (and Not Replace) It (4/5)

Video Transcription

Video Summary

The video discusses when open hip surgery is necessary in cases of failed hip arthroscopy. It mentions that open surgery is necessary for patients with hip dysplasia, specifically when the lateral center edge angle is less than 18 degrees. The Periacetabular Osteotomy (PAO) procedure, described by Reinhold Ganz in 1988, is recommended for hip dysplasia. The video also discusses Perthes disease, which is more commonly seen in pediatric patients but can also occur in adults. It provides an example of a patient with adult sequela of Perthes disease and explains the surgical procedures performed for this case. The video emphasizes the importance of a complete capsular closure in hip arthroscopy to avoid failure and accelerated arthritis. It discusses borderline hip dysplasia and highlights the need to consider other factors and perform a complete capsular closure in revision hip arthroscopy. The video also mentions the use of provocative maneuvers and radiographic measurements to identify borderline dysplasia and determines whether hip arthroscopy or open surgery is appropriate. It states that hip arthroscopy in borderline dysplasia is less predictable and presents a higher failure rate. The video suggests that femoral version abnormalities and surgical hip dislocation are situations where open surgery may be preferred over hip arthroscopy. Finally, it advises not to perform hip arthroscopy if there are indications for periacetabular osteotomy or total hip replacement. No specific credits were mentioned in the video.

Asset Caption

Andrea Spiker, MD

Keywords

open hip surgery

hip arthroscopy

hip dysplasia

Periacetabular Osteotomy

Perthes disease