144: Dr. Travis Matheney – Management of Borderline Hip Dysplasia (Part 2)

In this episode, we’re going to continue our discussion with Dr. Travis Matheney and focus on surgical treatment options for borderline hip dysplasia.Our conversation picks back up with a review article published in the December 2024 issue of Current Reviews in Musculoskeletal Medicine titled “Borderline Hip Dysplasia - Best Treated with Hip Arthroscopy or Periacetabular Osteotomy?” Dr. Andrea Spiker and colleagues summarized the current research comparing isolated hip arthroscopy to periacetabular osteotomy for patients with borderline hip dysplasia.  They noted improved postoperative clinical outcome scores and low rates of conversion to total hip arthroplasty in both groups.  The authors concluded that successful clinical outcome seem to rely on treating underlying clinical pathology as well as appropriate surgical indications and surgical techniques.Then, from the April 2021 issue of OJSM, we review an article titled “Comparison Between Hip Arthroscopic Surgery and Periacetabular Osteotomy for the Treatment of Patients With Borderline Developmental Dysplasia of the Hip.” This systematic review authored by Dr. Marc Philippon and his team at the Steadman Clinic in Vail found that outcomes improved across all patient reported outcome measures whether patients were treated using arthroscopic surgery or PAO.  They noted that revision surgery was also common in both procedures. We finish up with an article from the September 2017 issue of AJSM titled “Early Functional Outcomes of Periacetabular Osteotomy After Failed Hip Arthroscopic Surgery for Symptomatic Acetabular Dysplasia.” Bryan Kelly and his team at HSS investigated the effect of prior arthroscopic hip surgery on clinical outcomes after periacetabular osteotomy or “PAO”. They found that patients who previously underwent hip arthroscopy had inferior functional outcomes at 6 months and 12 months after PAO compared to patients with no prior hip surgery. The authors note that both groups significantly improved post-op and there was no difference in complications or reoperation between the groups.