Periacetabular Osteotomy With and Without Arthroscopic Management of Central Compartment Pathology

This study is comparing two surgical approaches for treating hip dysplasia (shallow hip socket) in young adults: the Bernese periacetabular osteotomy (PAO) alone versus PAO combined with hip arthroscopy to treat damage inside the hip joint at the same time. Hip dysplasia can cause pain, instability, and early arthritis if left untreated. The PAO surgery repositions the socket to give the hip better coverage and stability. Some patients also have cartilage or labral (tissue) damage inside the joint. This study asks whether addressing that inner-joint damage during the same surgery leads to better outcomes than the osteotomy alone. You may be eligible if: - You are between 16 and 50 years old with a mature skeleton - You are having a Bernese PAO for symptomatic hip dysplasia or instability - You have had a pre-operative MRI at 3T and/or a gadolinium MR arthrogram - You are able to provide informed consent You may NOT be eligible if: - You have had any prior hip or pelvis surgery on the same side - You have evidence of significant hip arthritis on imaging (Tonnis grade 2 or higher) - You have a known connective tissue, neuromuscular, or skeletal dysplasia disorder - You have had a prior hip replacement on either side - You have cognitive impairment affecting ability to complete questionnaires Talk to your doctor to see if this trial is right for you.