Hip joint-preserving surgery: beyond the classic osteotomy.

It has been postulated that hip osteoarthritis is often caused by developmental anatomic deformities. Recent studies have demonstrated that relatively subtle anatomic abnormalities such as acetabular retroversion, acetabular overcoverage, and decreased offset of the femoral head-neck junction also may lead to pain and osteoarthritis. Advances in surgical techniques such as the periacetabular osteotomy, safe surgical dislocation of the hip, and hip arthroscopy have provided the surgeon with effective and safe tools to correct these anatomic problems. Clinical and radiographic techniques are used to identify these anatomic abnormalities.