The evolution and concept of hip joint preservation surgery

By Leunig M. and Ganz R., The Bone and Joint Journal
The use of surgical techniques for preserving the hip joint had been largely abandoned following the advent of total hip arthroplasty. However, with the modification of techniques such as pelvic osteotomy, and the advent of intra-articular techniques such as surgical dislocation of the hip and arthroscopy, surgical treatment options became available for conditions arising from childhood problems, such as developmental dysplasia of the hip, slipped capital femoral epiphysis and Perthes disease, which had not been available in the past. In addition, femoroacetabular impingement has been identified as an important causative factor in the development of osteoarthritis in hips that were previously thought to be affected by primary osteoarthritis. As the mechanical causes of degenerative joint disease are now recognised earlier in the progression of the disease, these techniques may be regarded as slowing, or even preventing, the progression of osteoarthritis. In this article the authors review the recent development of these concepts and the associated surgical techniques.