In today’s episode, I speak with Dr. Ben Domb, a leading orthopedic surgeon and founder of the American Hip Institute in Chicago, a center dedicated to advancing hip treatments through education and innovation. 

We discuss a recent paper he published on the treatment of so-called Borderline Hip Dysplasia. The study found no significant difference in outcomes for the condition when patients underwent either a Periacetabular Osteotomy or arthroscopic capsular plication.

We talk about the nuances of borderline hip dysplasia, the difficulty in standardizing surgical treatment, and the development of a comprehensive center of excellence for treating hip pathology.

We consider the three core pillars of medicine: delivering high-quality patient care, advancing knowledge through research, and fostering education for clinicians and patients.

We examine the importance of tracking outcomes and balancing education with a busy practice.

We explore the evolution of the subspecialty of “hip preservation” and the various routes that one can take to become a hip preservation surgeon, as well as the trend in all of medicine to super-specialize

We also  touch on new mediums for transferring knowledge and  building a personal brand, amongst other things.

On today’s episode, I have the privilege of speaking with

Dr. Iobst recently experienced a life-changing event that

We discuss Overcommitment and people-pleasing, particularly among high-functioning professionals.

We talk about Societal pressures and internal motivations

We consider The importance of learning to say "no"

We then analyze some of the root causes of overcommitment, including fear and its many different forms

We talk about strategies to combat overcommitment and

prevent burnout, how to break the cycle of overcommitment, confront these fears, and set boundaries for better professional fulfillment and personal well-being.

This is an essential conversation for anyone striving to

This week I speak with Joel wells MD associate professor of orthopedic surgery at the University of Texas A&M and we discussed the complexities of the role that social media plays in patient perception and self reported outcomes specifically after having periacetabular osteotomy for the correction of acetabular dysplasia.

We talk about the complexities of social media in medicine and discuss how it is crucial to consider both the benefits and risks these platforms pose. Social media has become a powerful tool for sharing health information and connecting patients, it also has a darker side—one where misinformation, pseudoscience, and unchecked narratives can flourish.

The issue goes beyond just pseudoscience. Today we are seeing patients turn to social media to share their postoperative journeys, including complications, in ways that don’t always align with traditional clinical data. This raises important questions about how we validate patient experiences and the role that online platforms play in shaping perceptions of medical outcomes.

We explore these dynamics and their implications for both physicians and patients, with a particular focus on PAO surgery. 

We consider the fact that the most common complication reported was pain and that the complication posts were made late in the postoperative period, highlighting a potential disconnect between patient perception and clinical outcomes.

This week, join me for a recap and 'Ask Me Anything' episode! I've shifted to a bi-weekly or monthly format to better fit your schedules and allow you to catch up on past episodes. Over the last ten episodes, we’ve explored topics beyond the hip, including surgical techniques and medical publishing, and your feedback has been invaluable. Tune in as I answer your questions and delve into the topics you’ve been curious about. Keep those questions coming to keep our discussions engaging and relevant!

This week, I speak with Dr. Paul Beaulé, Professor and Chief of the Division of Orthopedic Surgery at the University of Ottawa, Canada. He has dedicated his career to understanding the hip and is a world-renowned author and hip preservation surgeon.

In our conversation, we delve into a recent randomized controlled trial he led and published. It compared the outcomes of patients undergoing arthroscopy in conjunction with periacetabular osteotomy versus those who did not have arthroscopy. This groundbreaking study earned the 2024 Hip Society Otto Aufranc Award.

We explore the complexities of conducting randomized controlled trials in orthopedic surgery, discuss the inherent variability in surgical procedures, and examine the nuances of interpreting MRI findings related to the acetabular labrum—a structure Dr. Beaulé has extensively researched.

We talk about the variability inherent to any surgical procedure.

We talk about the interpretation of MRI findings and the structure and function of the acetabular labrum, which he has described at length and worked diligently on for years.

Most of the discussion centers on the study's findings, which show no significant difference in clinical outcomes between the group undergoing arthroscopy and those that didn’t when undergoing a PAO. 

We also talk about alternatives, including hip replacement, as well as outcomes of hip replacement after having a  PAO, amongst other things. 

This week, I speak with Nancy Muir, a pediatric physical therapist based at the University of Colorado Aurora, beyond this, she is an expert on hip dysplasia, having been diagnosed running an ultra-marathon and she has been very forthcoming and gracious in sharing her story.

My relationship with Nancy spans several years, and we have worked closely together since she founded the nonprofit organization, Miles for Hips. This organization, which she established in partnership with the International Hip Dysplasia Institute, serves as a beacon of patient advocacy and awareness.

She shares her unique and often challenging journey with adult hip dysplasia, a story that many listeners may find relatable. She also delves into her decision-making process when she was considering surgery.

She talks about getting multiple medical opinions but still not finding the comprehensive information she needed about her condition, the treatment options, and potential outcomes.

We talk about a paper she is due to have published, which looks at decision aids for adult patients considering periacetabular osteotomy surgery, which she developed as part of the efforts to earn her title of Doctor of Health Science from Drexel University in 2023 

We discuss qualitative research and patient expectations of receiving information at a medical visit.

We consider so-called shared decision-making, what that term means, and why it has limitations.

We talk about individual needs to understand health conditions and their huge variation, from the level of detail they want to the type of information that helps make decisions.

She provides great insight and tools that patients and healthcare providers can apply to provide tailored treatment.

This week I talk with Deborah Eastwood of the Royal National Orthopedic Hospital in London, England.

The name Debbie Eastwood is synonymous with excellence in Orthopedics stands as a beacon of inspiration and is one of the most influential women in orthopedic surgery. Her remarkable contributions to pediatric orthopedics have left an indelible mark in the field. 

Debbie Eastwood's unwavering dedication was recently honored with the lifetime achievement award from the European pediatric orthopedic society. This prestigious recognition, coupled with her involvement in numerous national and international organizations, and her role as a teacher, is a testament to the clarity of her thought.

We begin reviewing her orthopedic journey and background. She discusses her initial approach to the developmental display of the hip and how she reached her opinions.

We consider why national screening programs do not appear to have been as successful as they should have been. 

We talk about historical differences in approaching the treatment of developmental dislocation of the hip on both sides of the Atlantic, 

We discuss her recent research looking at length discrepancy after the treatment of hip dysplasia and the reason behind this, 

We talk about genetics and the future of research for hip dysplasia, amongst other things.

This week, I speak with Dennis Wenger, the director of pediatric orthopedic surgery education emeritus at Rady Children's Hospital in San Diego, CA, and the professor of orthopedic surgery emeritus at the University of California, San Diego.

He has had a prolific career as a clinician educator and researcher in pediatric orthopedic surgery.

We discuss his approach to treating developmental dislocation of the hip, including different philosophies he learned from diverse parts of the world with a unique background.

 We talk about the state of specialized surgery of the musculoskeletal system in children in the United States.

 One of the highlights of our conversation was debating the technique he developed, which involves shortening and reattaching the ligamentum teres, and we talked about its inception, development, biomechanics, and clinical results. 

We discuss a few alternatives, including a temporary transarticular pin and the importance of achieving stable concentric reduction.

 Of course, no conversation with Dennis Wenger would be complete without some intriguing philosophical insights. 

 We talk about the difficulties with learning to perform these procedures given the, fortunately, decreasing number of late detected dislocations around the world, among other things. 

This week I have two guests; I welcome Anders Falk Brekke, who is a registered physical therapist and PhD, affiliated with the Department of Physiotherapy at University College Absalon, Region of Zealand, Denmark, the Orthopaedic Research Unit, Department of Clinical Research, University of Southern Denmark and the Department of Orthopaedics and Traumatology, Odense University Hospital, Denmark.

Josefine E. Naili is also a registered physiotherapist and PhD associate professor of physiotherapy. Currently conducting research at the Department of Women’s and Children’s Health and working clinically in the Motion Analysis Lab at Karolinska University Hospital in Stockholm, Sweden.
They both have extensive research interests, including evaluating the impact of musculoskeletal disease and injury on movement and gait patterns.

We talk about the mechanics of gait and the prevalence of Increased anterior pelvic tilt in patients with acetabular retroversion compared to the general population.

We discuss acetabular retroversion, how it affects hip function, its typical symptoms, and clinical presentation and radiographic evaluation.

We talk about the lack of evidence to support non-surgical treatments to change excessive anterior pelvic tilt in both symptomatic and asymptomatic adults and their efforts to prove the feasibility of an intervention consisting of an exercise program  to change this

We end with a discussion of a paper they published in February 2023, which discusses the changes in functional biomechanics following a targeted exercise intervention for patients with acetabular retroversion and femoroacetabular impingement syndrome. They discuss how the intervention showed changes in the range of motion flexion and reduced anterior pelvic tilt; however, it did not change gait biomechanics or patient-reported pain.

We discuss patient adherence and its importance in any physical therapy program and discuss future research in the field, among other things.

This week I speak with Laura Rutterford a physical therapist based in the United Kingdom.

This is a so-called crossover podcast, as she also has a podcast called Help for Hip Dysplasia, which I highly encourage you to check out.

Today, Laura shares her journey with hip dysplasia, which inspired her to become a physical therapist. This is not uncommon in the world of hip dysplasia; people who have been affected often become strong advocates.

We talk about her treatment approach and the importance of collaborative care.

We discussed screening programs and the inadequacy of many of these

We consider the rationale and basis for physical therapy in helping patients with hip dysplasia

She clarifies some misconceptions surrounding physical therapy

We talk about an individualized approach but also standardizing treatment to have a greater reach worldwide

We discuss potential areas for future research and improvement in the field and emerging trends.