Hip PRESERVATION
Hip preservation is based on the idea that some common hip problems, when identified early, can be addressed with a surgical intervention to improve the mechanics of the hip joint. The goal is to delay or prevent the development of painful arthritis, which often leads to a total hip replacement in many patients.
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The procedures are typically performed on teenagers and young adults before damage to the joint have occurred, but there is no age limit. Conditions such as hip dysplasia (shallow hip socket), femoroacetabular impingement (FAI), and other conditions such as avascular necrosis (AVN), Perthes disease, and slipped capital femoral epiphysis (SCFE) have a higher likelihood of developing hip arthritis. Over time, these conditions can lead to a mechanical problem around the hip that is painful, especially with certain activities. Sometimes, an MRI may identify a cartilage injury or labral tear. If the underlying cause of the abnormal mechanics is identified and treated, often the symptoms can improve substantially, and in many patients resolve entirely before damage to the joint becomes irreversible.
Examples of hip preservation procedures include hip arthroscopy, periacetabular osteotomy, surgical hip dislocation, and femoral osteotomy. These techniques can also be used to address any secondary pathology that may have occurred, such as a labral tear or cartilage injury.
Many of the hip conditions that could benefit from hip preservation procedures started in childhood or adolescence. Some conditions, such as hip dysplasia, are screened for at a very young age in at-risk populations. But for some patients, the condition may not always be detected until later in life. Similarly, conditions such as femoroacetabular impingement (FAI) tend to develop slowly over time, starting in adolescence, and may not be symptomatic until patients are in their second or third decade.
Not all hip conditions require surgical treatment. Some may improve substantially with activity modification and focused physical therapy.
Conditions that may benefit from hip preservation include:
- Hip dysplasia, from infants to adults.
- Femoroacetabular impingement (FAI).
- Labral tears.
- Perthes disease.
- Slipped capital femoral epiphysis.
- Avascular necrosis.
- Post-traumatic hip deformity.
