Hip preservation surgery maintains the natural hip joint by correcting underlying anatomical issues or addressing early-stage damage. This surgical approach aims to alleviate pain, improve function, and delay or prevent the need for a total hip replacement. Unlike hip replacement, which uses artificial components, hip preservation restores the native joint’s health and biomechanics. It is beneficial for younger, active individuals with hip pain due to structural problems.
Understanding Hip Preservation Surgery
Hip preservation surgery is a specialized orthopedic intervention designed to correct structural problems within the hip joint before they lead to irreversible damage or arthritis. The primary goal is to salvage the natural joint by addressing the root cause of pain and dysfunction, rather than replacing it. This approach is distinct from hip replacement surgery, where the damaged ball and socket are replaced with artificial implants. Hip preservation aims to extend the life of a patient’s own hip joint.
This surgical philosophy focuses on restoring the optimal biomechanics of the hip, ensuring joint surfaces move smoothly and distribute weight properly. By intervening early, surgeons prevent further cartilage degradation and the progression of conditions that might necessitate a total hip replacement. This strategy is recommended for younger patients without significant arthritis, helping them maintain an active lifestyle and reducing the likelihood of needing multiple hip replacements.
Hip Conditions Requiring Preservation
Several conditions commonly lead to hip pain and dysfunction in younger, active individuals, making them candidates for hip preservation surgery. Femoroacetabular impingement (FAI) is a frequent cause, where irregular bone shapes on the femoral head or acetabulum cause friction and damage during hip movement. This can lead to labral tears, which involve damage to the cartilage ring providing stability to the hip joint.
Hip dysplasia is another condition, characterized by a shallow hip socket that does not adequately cover the femoral head, leading to instability and increased cartilage wear. This insufficient coverage can result in early onset osteoarthritis. Avascular necrosis (AVN), the death of bone tissue due to lack of blood supply, may also be treated in its early stages before significant femoral head collapse. These interventions correct underlying anatomical issues to alleviate symptoms and slow joint degeneration.
Key Surgical Techniques
Hip preservation surgery encompasses various techniques tailored to specific hip conditions. Hip arthroscopy is a minimally invasive procedure used to treat conditions like FAI, labral tears, and to remove loose bodies. During arthroscopy, a surgeon makes small incisions to insert a camera and specialized instruments, allowing them to visualize and repair damaged structures, such as reattaching a torn labrum or reshaping bone. This approach is often outpatient, contributing to less post-operative pain and faster recovery.
For complex structural issues, particularly hip dysplasia, open surgical techniques like osteotomies are employed. A periacetabular osteotomy (PAO) involves precisely cutting the bone around the acetabulum to reposition the hip socket for better femoral head coverage. This realignment restores normal hip joint anatomy, improves stability, and distributes weight more effectively.
Screws stabilize the repositioned bone until new bone forms and fuses. Femoral osteotomy involves cutting and realigning the thigh bone to correct deformities and improve hip mechanics. These techniques can be combined to address multiple issues, optimizing the hip’s long-term health.
Post-Operative Journey and Future
Recovery following hip preservation surgery involves a structured rehabilitation program to restore strength, mobility, and function. Immediately after surgery, pain is managed with medication and ice. Physical therapy begins early, often within 24 hours, focusing on gentle motion and gradual progression to weight-bearing exercises. Crutches or a walker are common during initial weeks to protect the healing joint.
Recovery timelines vary based on the specific procedure, individual health, and commitment to rehabilitation, but a full return to activity can take several months. Light daily activities might be possible within 6 to 12 weeks, while strenuous activities or sports may require 3 to 6 months or up to a year, particularly after extensive procedures like PAO. Long-term outcomes include pain relief, improved hip function, and the ability to maintain an active lifestyle. Studies indicate high success rates, with many hips remaining functional and pain-free for 10 to 20 years, potentially delaying or preventing hip replacement, especially when surgery is performed before advanced arthritis develops.