Periacetabular Osteotomy and Arthroscopic Labral Repair After Failed Hip Arthroscopy Due to Iatrogenic Aggravation of Hip Dysplasia
Authors: Jackson TJ, Watson J, LaReau JM, Domb BG
DOI: 10.1007/s00167-013-2540-x
Purpose
To present a case where hip arthroscopy in a patient with significant hip dysplasia worsened symptoms, and subsequent combined arthroscopic labral repair with periacetabular osteotomy (PAO) resulted in good outcomes.
Methods
Case report describing the clinical course of failed hip arthroscopy in dysplasia, followed by revision surgery with PAO and labral repair.
Key Findings
- Isolated hip arthroscopy can exacerbate symptoms in patients with untreated hip dysplasia.
- Combined PAO and arthroscopic labral repair addresses both bony deformity and soft tissue injury.
- Successful clinical outcomes observed at 2-year follow-up.
Conclusion
Hip arthroscopy alone should be cautiously indicated in patients with hip dysplasia. When dysplasia is present, combined PAO and labral repair may be necessary for optimal results.
What Does This Mean for Providers?
- Providers should carefully evaluate for hip dysplasia prior to arthroscopy; isolated arthroscopy may be contraindicated or insufficient.
- Consider combined surgical approaches addressing both acetabular morphology and labral pathology to optimize patient outcomes.
- Early identification of iatrogenic worsening post-arthroscopy should prompt consideration of corrective osteotomy and labral repair.