Editorial Commentary: Hip Arthroscopy in Dysplastic Hip Population? A Must, a Maybe, or a No Go?

Treating symptomatic patients with dysplasia involves a controversy in therapy. The question is whether to obtain osseous correction with the help of pelvic reorientation osteotomy or to address intra-articular pathology with an arthroscopic approach. Neither isolated therapy nor the other method seems to be sufficient, but conducting both treatment options simultaneously has also not proved to be superior and carries the risk of additional complications. Different treatment options have been presented on this topic over the years and should be considered on a case-by-case basis. Pelvic reorientation osteotomy in patients with moderate to severe acetabular dysplasia remains uncontested, but it lacks the ability to obtain visualization of the central hip compartment. The isolated arthroscopic approach seems to be favorable for treatment of intra-articular pathologies in patients with mild to borderline dysplasia, whereas collateral arthroscopy in pelvic reorientation osteotomy may achieve better clinical outcomes in patients with more complex cases.