What Causes the Need for Hip Preservation Surgery?

Hip preservation surgery is often considered when individuals experience symptoms such as pain, stiffness, or restricted movement in the hip joint that do not improve with conservative treatments like physical therapy, medications, or lifestyle changes. Conditions that may require hip preservation surgery include:

• Femoroacetabular Impingement (FAI): Abnormal contact between the hip ball and socket due to excess bone growth, leading to cartilage and labral damage.
• Hip Dysplasia: A condition where the hip socket is shallow or misaligned, causing instability and increased wear on the joint.
• Labral Tears: Damage to the labrum, the cartilage ring surrounding the hip socket, which can cause pain and instability.
• Cartilage Lesions: Areas of damaged cartilage that can lead to arthritis if left untreated.

These conditions can arise from genetic factors, repetitive stress, trauma, or congenital abnormalities.

Is Surgery Necessary for Hip Preservation?

Surgery for hip preservation is considered when non-surgical treatments are insufficient to manage symptoms or halt the progression of joint damage. The decision to undergo surgery depends on the extent of the condition, the patient's overall health, and their activity levels and goals. Hip preservation surgery is often recommended for younger, active patients who wish to maintain their natural hip joint for as long as possible and delay the need for a total hip replacement.

How is Hip Preservation Surgery Performed?

Hip preservation surgery includes a variety of techniques, depending on the specific condition being treated:

1. Arthroscopy: A minimally invasive procedure where a small camera (arthroscope) and specialized instruments are inserted through small incisions to treat labral tears, remove loose bodies, or reshape bone structures.
2. Osteotomy: A surgical procedure that involves cutting and repositioning the bones around the hip joint to improve alignment and reduce joint stress. This is often used for conditions like hip dysplasia.
3. Periacetabular Osteotomy (PAO): A type of osteotomy specifically used to treat hip dysplasia by reorienting the hip socket to better cover the ball of the hip joint, thereby improving stability and reducing pain.
4. Cartilage Repair and Restoration: Techniques like microfracture, autologous chondrocyte implantation (ACI), or osteochondral autograft transplantation (OAT) are used to repair or regenerate damaged cartilage.

These procedures are typically performed under general anesthesia and require a careful post-operative rehabilitation plan.

What's Next After Hip Preservation Surgery?

Recovery after hip preservation surgery involves a comprehensive rehabilitation program tailored to the specific procedure performed and the patient's needs:

• Initial Recovery: Patients may need to use crutches or other assistive devices to reduce weight-bearing on the hip initially. Pain management and measures to reduce swelling are important during this phase.
• Physical Therapy: A critical component of recovery, physical therapy focuses on restoring range of motion, improving strength, and gradually increasing activity levels. Therapy typically begins soon after surgery and progresses over several weeks to months.
• Follow-Up Care: Regular follow-up appointments with the surgeon are necessary to monitor healing, assess the success of the procedure, and address any complications or concerns.
• Activity Modification: Depending on the surgery and the patient's condition, modifications to activity levels and movements may be necessary to protect the hip joint and ensure long-term success.

With appropriate surgical intervention and a diligent rehabilitation program, patients can experience significant pain relief, improved joint function, and a delay in the progression of hip joint degeneration. This approach allows for an active lifestyle and can potentially postpone or eliminate the need for hip replacement surgery.