ABJS Carl T. Brighton Workshop on Hip Preservation Surgery: Editorial Comment

Excerpt

Interest in hip-preserving surgery has substantially increased during recent years. The increased interest is based on newly added knowledge of underlying pathomechanical disorders. Long-known major reasons for early hip dysfunction or premature onset of osteoarthritis are developmental or acquired hip deformities, including developmental dysplasia of the hip (DDH), childhood affections with residual deformities after Legg-Calvé-Perthes disease (LCPD) or slipped capital femoral epiphysis (SCFE), and sequelae of hip trauma or infection. Additional and sometimes subtler deformities can also contribute to early hip osteoarthritis. Harris and colleagues [5, 12] described one of the earliest recognized and perhaps best known of these deformities: the “pistol grip” deformity of the femoral head. A few decades later, a new pathomechanism called femoroacetabular impingement (FAI) provided an explanation and a substantial link between a pistol grip deformity and/or acetabular overcoverage with hip osteoarthritis. This concept was developed by Reinhold Ganz and his coworkers [4]. The concept of FAI has substantially contributed to the understanding of a painful hip in the young adult and, together with further developments of surgical techniques, has enlarged the spectrum of joint-preserving surgeries. The main goal of this workshop can be condensed to three questions according to the concept of the ABJS Carl T. Brighton workshops: (1) Where are we now in the field of joint-preserving surgery? (2) Where do we need to go? (3) How do we get there? …