At present, it is not clear whether performing a hip arthroscopy at the same time as a PAO improves patient outcomes after surgery compared to a PAO alone.
This research project will randomize patients to receive either a PAO alone, or a PAO and a hip arthroscopy at the same time.
Skeletally mature patient undergoing Bernese periacetabular osteotomy for symptomatic acetabular dysplasia/hip instability
Pre-Operative MRI at 3T and/or gadolinium MR arthrogram
Age, 16-50 years old
Patient capable of giving informed consent
Prior hip/pelvis surgery of any kind on the surgical side
Prior hip arthroplasty surgery on either side
Radiographic evidence of arthritis (i.e. Tönnis grade =2)
Known connective tissue disorder (e.g. Ehlers-Danlos Syndrome, etc.)
Parallel
PAO with hip arthroscopy
Procedure/SurgeryParticipants who are randomized to the Scope-PAO group will receive central compartment hip arthroscopy in addition to the PAO.
PAO without hip arthroscopy
Procedure/SurgeryParticipants who are randomized to the "PAO-only" group will receive a Bernese Periacetabular Osteotomy (PAO) for treatment of hip dysplasia.
iHOT-33
Patient-reported quality of life will be the primary outcome used for comparison between the two treatment groups as measured by the International Hip Outcome Tool (iHOT-33). The iHOT-33 is a validated, self-administered quality of life assessment tool for young, active patients with hip symptoms.
HOOS
Hip-specific symptoms and functional impairment will be compared using the Hip Disability and Osteoarthritis Outcome Score (HOOS). This 40-item patient reported outcome tool has been validated for use in patients with and without hip osteoarthritis and has shown good responsiveness, reliability and reproducibility in this patient population.
PROMIS Global 10
Global Health assessment will be compared using the PROMIS Global 10 Score. This 10-item tool assesses general domains of health related quality of life in the domains of physical, mental, and social well-being.
Operative time
Total operative time is expected to be longer in the "Scope-PAO" treatment group, however the average increase in time will be valuable information for future research assessing cost-effectiveness of this treatment strategy. Total operative time will be measured from the time the patient enters the operating room to the time the patient is ready for transfer to post-anesthetic care unit (PACU). This time interval represents the best assessment of the overall time cost to the health care system associated with the surgical procedure while avoiding confounding due to delays in transfer to PACU.
Hospital Length of Stay
Length of stay, measured in days, will be assessed from date of admission to date of discharge up to one month.
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