Hip preservation is a relatively new concept in pediatric and young-adult orthopedic surgery.
The goal of hip preservation treatment is to delay or prevent the onset of end-stage hip osteoarthritis. Strategies to halt the progression of hip osteoarthritis in young adults are important, as that condition can lead to significant discomfort and poor quality of life. In these individuals, a hip joint replacement is often the only solution. Although a hip replacement has an excellent outcome, there is concern for the longevity of the artificial joint, especially in the young and active patient. Therefore, it is optimal to avoid or postpone hip joint replacement surgery.
Bony abnormalities in either the femoral head or the acetabulum (hip socket) can result in hip pain and cartilage injury, which leads to osteoarthrosis. These bony deformities are often the result of childhood hip disorders such as developmental dysplasia (hip dysplasia), Legg-Calvé-Perthes disease, or slipped capital femoral epiphysis. A relatively new concept called the femoroacetabular impingement (FAI) describes abnormalities of the femoral head or acetabulum that cause hip pain and cartilage injury while the hip moves during rigorous activities such as sports.
Theoretically, hip preservation begins in the newborn child, with the diagnosis and treatment of hip dysplasia. Hip dysplasia in a skeletally immature child can be managed with a variety of bony surgical procedures on the pelvis and acetabulum.
In adolescents and young adults, novel surgical techniques have been developed to improve the bony abnormalities that can lead to hip osteoarthritis. The following are the latest surgical techniques in hip preservation: