Grant: Project Grant

Hip dysplasia is one of the most common causes of hip arthritis. Many patients with hip dysplasia experience years of painful hip symptoms that interfere with activity and quality of life before arthritis develops. The Bernese periacetabular osteotomy (PAO) is a procedure that reorients the acetabulum (hip socket) and has been used successfully for over 30 years to treat the symptoms of hip dysplasia and delay the onset of arthritis. Unfortunately, some patients have symptoms that persist after PAO surgery for problems inside the hip joint that could not be corrected with a PAO alone. Hip arthroscopy is a surgical procedure performed using a small camera that allows surgeons to see and address problems like cartilage and labral tears inside the hip joint. Although both procedures are considered standard of care treatment options, it is unknown whether or not the addition of the hip arthroscopy to PAO surgery adds value to the patient and the healthcare institution when compared to a PAO alone. Furthermore, the association between hip arthroscopy outcomes and cartilage quality is not well elucidated in the literature. The quality of the cartilage can be assessed by a noninvasive magnetic resonance imaging (MRI) technique called T1rho that enables the evaluation of early cartilage changes. As such, this study will recruit 126 participants undergoing a PAO for hip dysplasia across two sites in Canada and two sites in the United States. Patients will be randomized to receive a PAO alone or a PAO and a hip arthroscopy simultaneously. Both groups will be compared in terms of quality of life and health system costs. Furthermore, a sub-group of patients (18 in each group) will receive a T1rho MRI before and after surgery to study changes in cartilage quality over time.