Description
This podcast episode features Nigel Kiely and a panel of orthopedic surgeons discussing hip disorders, particularly focusing on the transition from pediatric to adult orthopedic services. The session revolves around a specific case involving an 18-year-old patient with right groin pain and mild hip dysplasia as seen on an X-ray. The panel includes Aresh Hashemi Nejad, a consultant with expertise in pediatric and adult hip disorders, Tim Board, who specializes in hip arthroscopy and arthroplasty, and Geraint Thomas, a senior lecturer involved in hip preservation.
Key points include:
- The importance of assessing the X-ray views to understand the patient's condition, including considerations of the pelvic inlet and femoral shape.
- Discussion on imaging choices to evaluate hip dysplasia comprehensively, including long leg standing films and 3D CT scans for a better understanding of acetabular and femoral morphology.
- The debate surrounds the clinical significance of labral tears found on imaging and how they relate to the patient's pain.
- The panelists emphasize conservative management, such as therapy and rehabilitation, before considering surgical options like periacetabular osteotomy or hip arthroscopy, depending on the severity of the dysplasia and patient symptoms.
- They also discuss the variable nature of hip dysplasia's progression to arthritis, noting that not all cases lead to pain or the need for replacement surgery. Ultimately, the conversation illustrates the complexity of diagnosing and managing hip disorders in young patients and the collaborative expertise required at the interface between pediatric and adult care.