Hip Preservation: Protecting Your Natural Hip Joint for Long-Term Mobility

What Is Hip Preservation?

Hip preservation is a set of advanced treatments designed to repair and restore the natural hip joint before damage becomes severe enough to require a hip replacement.
This approach is especially beneficial for younger, active patients who have hip pain caused by structural or mechanical issues but whose cartilage and bone are still largely healthy.

The goal of hip preservation is simple yet powerful: relieve pain, restore function, and prevent or delay the development of arthritis by addressing the underlying cause of hip problems early.

Why Hip Preservation Matters

The hip is a ball-and-socket joint that supports much of your body weight and allows a wide range of movement. Over time, or due to injury or abnormal joint structure, the hip can become damaged. When this happens, the cartilage that cushions the joint may wear away, leading to arthritis.

Unlike hip replacement surgery, which replaces the damaged joint with artificial components, hip preservation techniques aim to keep your natural joint intact for as long as possible.
By correcting structural problems early—sometimes even before arthritis appears—hip preservation can extend the life of your joint and keep you active.

World-Class Validation from ISHA

Our approach to hip preservation reflects international standards developed by the International Society for Hip Preservation (ISHA)—the global authority in hip preservation. ISHA defines hip preservation as restoring and maintaining the natural hip joint to relieve pain and delay osteoarthritis. The Society produces free patient education, virtual learning for clinicians, and globally recognized consensus guidelines—such as rehabilitation protocols for femoroacetabular impingement (2019) and greater trochanteric pain syndrome (2022)—that guide our treatment planning.

ISHA’s expanding global initiatives—like its educational programs, screening missions, and Annual Scientific Meetings—help shape the future of hip preservation care and ensure our practice remains at the forefront.

Conditions Treated With Hip Preservation

  1. Femoroacetabular Impingement (FAI)
  • FAI occurs when extra bone develops on the ball (femoral head) or socket (acetabulum) of the hip joint.
  • These bony growths cause abnormal contact during movement, which can damage cartilage and tear the hip labrum.
  • Hip preservation surgery reshapes the bone to restore smooth, pain-free motion.
  1. Hip Dysplasia
  • In hip dysplasia, the hip socket is too shallow to fully cover and support the ball of the hip joint.
  • This causes uneven pressure on the cartilage and labrum, which can lead to early wear.
  • Surgery such as a periacetabular osteotomy (PAO) repositions the hip socket to improve coverage and stability.
  1. Labral Tears
  • The labrum helps keep the ball of the hip joint securely in place and acts as a shock absorber.
  • Tears from injury or repetitive motion can cause pain, catching, or instability.
  • Arthroscopic repair can restore labral function and help protect the joint.
  1. Cartilage Damage
  • Localized cartilage defects may be repaired or smoothed to reduce pain and prevent further breakdown.
  1. Other Conditions

Hip preservation techniques can also be used for:

  • Avascular necrosis (loss of blood supply to the femoral head)
  • Perthes disease (childhood hip disorder)
  • Slipped capital femoral epiphysis (SCFE)
  • Snapping hip syndrome
  • Tendon or muscle injuries around the hip

Treatment Options for Hip Preservation

Nonsurgical Approaches

Not every hip condition requires surgery right away. Early-stage hip problems may improve with:

  • Activity modification to reduce joint stress
  • Physical therapy to strengthen muscles and improve hip mechanics
  • Anti-inflammatory medications for pain control
  • Image-guided injections (such as corticosteroids or platelet-rich plasma) to reduce pain and inflammation

If these measures fail to provide lasting relief, surgical options are considered.

Surgical Techniques

Hip Arthroscopy

  • A minimally invasive procedure using small incisions and a camera to access the joint
  • Can repair labral tears, reshape bone in FAI, remove loose cartilage, or treat minor cartilage damage
  • Often performed on an outpatient basis with shorter recovery times
  • Learn more about hip arthroscopy.

Periacetabular Osteotomy (PAO)

  • Used for hip dysplasia
  • The surgeon cuts and repositions the hip socket to better cover the ball of the joint, distributing pressure more evenly
  • Can dramatically reduce pain and improve function while delaying arthritis

Femoral Osteotomy

  • Reshapes or repositions the femur (thigh bone) to improve joint alignment

Surgical Hip Dislocation

  • Allows full access to the hip joint for complex repairs without damaging the blood supply to the femoral head
  • Used for advanced deformities or cases where arthroscopy alone isn’t enough

Benefits of Hip Preservation Surgery

  • Preserves your natural hip joint for as long as possible
  • Delays or prevents the need for hip replacement—especially important for younger patients
  • Relieves pain and improves mobility so you can return to sports, work, and daily life
  • Addresses the root cause of hip damage, not just the symptoms

Who Is a Candidate for Hip Preservation?

You may be a good candidate if:

  • You are under 50 (though older patients with minimal arthritis may still benefit)
  • You have hip pain that limits activity
  • Imaging (MRI or X-ray) shows a structural problem but little or no arthritis
  • Nonsurgical treatments haven’t solved the problem

The earlier the intervention, the better the outcome. Once arthritis becomes advanced, hip preservation surgery is generally less effective, and hip replacement may be necessary.

Recovery and Rehabilitation

Recovery times vary depending on the procedure:

  • Hip arthroscopy: Many patients return to light activities within a few weeks and full activities in 3–6 months
  • PAO or osteotomy: Recovery may take 6–12 months with gradual return to sports or high-impact activities

A tailored orthopedic rehabilitation program is essential to restore strength, flexibility, and joint control.

Why Choose [Your Practice Name] for Hip Preservation

At [Your Practice Name], our fellowship-trained orthopedic surgeons have advanced expertise in both minimally invasive and open hip preservation techniques.
We take a comprehensive, patient-centered approach, beginning with a thorough evaluation that includes:

  • Detailed history and physical examination
  • State-of-the-art imaging to identify early joint changes
  • Collaborative treatment planning to match your activity goals

Our goal is to keep you moving for years to come, using the latest surgical innovations supported by research from leading institutions like Mayo Clinic, Johns Hopkins, and the National Institutes of Health.

Hip Preservation FAQ

What is hip preservation?

Hip preservation refers to treatments—both surgical and nonsurgical—aimed at correcting problems in the hip joint to relieve pain, improve function, and prevent or delay arthritis. The goal is to protect your natural joint rather than replace it.

How do I know if I need hip preservation surgery?

You may be a candidate if you have ongoing hip pain, especially during activity, and imaging shows a structural problem such as femoroacetabular impingement (FAI), hip dysplasia, or a labral tear—but without advanced arthritis. A hip specialist can confirm whether hip preservation is right for you.

What are the benefits of hip preservation surgery?

Benefits can include:

  • Relief from pain
  • Improved mobility and strength
  • Preservation of your natural hip joint
  • Delayed or avoided hip replacement in the future

What’s the difference between hip arthroscopy and hip replacement?

Hip arthroscopy is a minimally invasive hip preservation technique that repairs existing tissue and reshapes bone to improve joint function. Hip replacement involves removing damaged bone and cartilage and replacing them with artificial components. Preservation is usually preferred for younger patients without severe arthritis.

How long does recovery take?

Recovery time depends on the procedure:

  • Hip arthroscopy: 3–6 months for most activities
  • Periacetabular osteotomy (PAO) or femoral osteotomy: 6–12 months
    Your orthopedic surgeon will provide a personalized rehabilitation plan.

Is hip preservation only for athletes?

No. While athletes often benefit, hip preservation is for anyone—active or not—who has a correctable structural issue in the hip and wants to maintain joint health.

Will I still need a hip replacement later?

Possibly, but successful hip preservation can delay the need for replacement by many years, allowing you to stay active with your natural joint for as long as possible.

Request a Consultation

If you have hip pain that isn’t improving, you don’t have to wait until it becomes severe.
Schedule an evaluation with our hip preservation specialists today and learn how protecting your natural joint now can keep you active, mobile, and pain-free for the future.