Degenerative Hip Joint Pain – The Non-Arthroplasty Surgical Options

Degenerative Hip Joint Pain (DHJP) is a major cause of functional limitation in both young active and old sedentary patients. Total hip arthroplasty (THA) is one of the most successful surgical procedures performed in orthopaedics. Sir John Charnley introduced the concept of low friction arthroplasty for end stage hip arthritis. The rewarding result of this procedure makes THA the gold standard for the treatment of end stage degenerative hip disease. In a recent retrospective study to establish the implant survivorship after THA in young patient at 25 years follow up, up to 89% (80%-98%) survivorship was reported among patients who were diagnosed with developmental dysplasia, 85% (77%-93%) in patients diagnosed with rheumatoid arthritis and 74% (61%-87%) in patients group with idiopathic degenerative arthritis of the hip[1]. Despite improved surgical technique, implant biomaterial and prosthesis design, complications such as recurrent dislocation, osteolysis and loosening still exist. Failure of THA may present with particular problems when revision arthroplasty is needed in young patient, which makes hip joint preservation techniques still actual in this population (hip arthroscopy, surgical dislocation with osteochondroplasty, periacetabular osteotomy, proximal femur osteotomy), and put back on track older surgical procedures such as hip fusion or resection arthroplasty for certain rare indications.