Hip preservation surgery for young adults with femoroacetabular impingement, hip dysplasia, and acetabular retroversion. Literature review

Introduction: Hip preservation techniques for young adults with structural abnormalities (FAI, dysplasia, retroversion) aim to prevent joint degeneration. This review assesses surgical innovations, outcomes, and unresolved challenges in the field. Materials and Methods: A literature search across PubMed, Scopus, Web of Science, e-Library. identified 45 studies. Inclusion criteria: focus on joint preservation surgery, comparative analysis of techniques (PAO, arthroscopy, surgical dislocation), and ≥5-year follow-up. Excluded: case reports, animal studies. Results: Hip arthroscopy shows favorable short-term outcomes for FAI (mHHS 85.9±12.1), yet 4.2 % require conversion to arthroplasty. Surgical dislocation of the hip allows surgeons who do not have hip arthroscopy to correct pronounced deformity with femoroacetabular impingement, as well as to suture a massive rupture of the acetabulum lip with minimal risk of avascular necrosis but correlates with pseudarthrosis and heterotopic ossification. PAO provides 91.3% (95 % Cl: 87.7–94.8 %) of 10-year survivorship; however, The survival of the hip joint after periacetabular osteotomy was influenced by the presence of correction errors and the initial condition of the hip joint. The following issues also remain unresolved: standardization of protocols, minimization of complications, individualization of approaches. The integration of digital technologies and biomechanical research will expand the indications for organ-preserving operations.