HIP Preservations
Hip Preservation Surgery
Hip preservation is based on the idea that some common hip problems, when identified early, can be addressed with a surgical intervention to improve the mechanics of the hip joint. The goal is to delay or prevent the development of painful arthritis, which often leads to a total hip replacement in many patients. The procedures are typically performed on teenagers and young adults, before damage to the joint has occurred, but there is no age limit. Conditions such as hip dysplasia, femoroacetabular impingement (FAI), and other conditions such as avascular necrosis (AVN), Perthes disease, and slipped capital femoral epiphysis (SCFE) have a higher likelihood of developing hip arthritis, if neglected. Over time, these conditions can lead to a mechanical problem around the hip that is painful, especially with certain activities.
Many of the hip conditions that could benefit from hip preservation procedures started in childhood or adolescence. Some conditions, such as hip dysplasia, are screened for at a very young age in at-risk populations. But for some patients, the condition may not always be detected until later in life. Similarly, conditions such as femoroacetabular impingement (FAI) tend to develop slowly over time, starting in adolescence and may not be symptomatic until patients are in their second or third decade.
Dr. Durga Prasad Valleri is a distinguished hip preservation surgeon with specialized training from two renowned institutions. Ganga Hospital and the Amara Hip Preservation Centre. With a strong foundation in cutting-edge techniques and extensive experience in hip preservation, Dr. Valleri is dedicated to providing exceptional care and innovative solutions for patients. His expertise includes advanced surgical and non-surgical treatments aimed at alleviating pain, improving function, and enhancing the quality of life for individuals with hip disorders. Dr. Valleri's commitment to excellence and patient-centered approach makes him a trusted name in hip preservation surgery.
Basic Principles and four pillars of hip preservation: 1. Availability of healthy cartilage 2. To provide impingement free motion 3. To correct instability (dysplasia) 4. To optimize hip abductors function
Conditions that may benefit from hip preservation surgeries:
Hip Dysplasia (DDH), from infants to adults
Slipped Capital Femoral Epiphysis (SCFE)
Perthes Disease
Coxa Vara
Proximal Femur Focal Deficiency (PFFD) And Congenital Short Femur
Femoroacetabular Impingement (FAI)
Post Septic sequel of Hip
Avascular Necrosis (AVN)
Cartilage And Bone Grafts
Tumors Around Hip Joint
Post traumatic hip deformity
Hip Arthroscopic procedures:
Femoro-acetabular impingement – cam osteoplasty, rim trimming, labral repair and reconstruction
Loose body removal
Synovial disorders like PVNS
Septic arthritis of hip joint
Cartilage disorders
Open hip preservation procedures:
Safe Surgical dislocation (SSD) approach
Modified Dunn’s procedure for SCFE
Proximal femur osteotomies (femoral Neck osteotomy, varus and valgus osteotomies) Head reduction osteotomy
Relative neck lengthening (RNL)
Periacetabular osteotomies (PAO)
Triple pelvic osteotomy and other acetabular osteotomies (Pemberton, Dega…)
Colonna capsular interposition arthroplasty
SUPER Hip procedure for PFFD
Frequently Asked Questions
What is hip preservation surgery?
Hip preservation surgery refers to procedures designed to treat structural or mechanical problems of the hip while preserving the patient's natural hip joint, rather than replacing the joint.
It may be considered for selected patients with conditions such as hip impingement, labral injuries, hip dysplasia and other problems that can damage the hip joint.
The appropriate procedure depends on the patient's specific diagnosis and the condition of the hip joint.
Who may benefit from hip preservation surgery?
Hip preservation surgery may be considered for patients, particularly younger or active adults, who have persistent hip pain caused by a structural problem that can potentially be corrected or treated while the natural joint remains suitable for preservation.
Factors considered include:
Age and activity level
Cause and duration of hip pain
Hip structure and alignment
Cartilage condition
Labral damage
Imaging findings
Response to non-surgical treatment
Not every patient with hip pain is a candidate for hip preservation surgery.
What conditions can hip preservation surgery treat?
Depending on the patient's condition and surgical assessment, hip preservation procedures may be considered for:
Femoroacetabular impingement
Hip labral tears
Hip dysplasia
Certain cartilage injuries
Structural abnormalities of the hip
Selected early degenerative hip conditions.
Early diagnosis is important because advanced cartilage damage or severe arthritis may change the available treatment options.
What is hip impingement?
Femoroacetabular impingement, or hip impingement, occurs when the shape of the hip joint causes abnormal contact between the bones during certain movements.
It may cause groin or hip pain, stiffness and difficulty with activities such as running, squatting or prolonged sitting.
Treatment depends on the severity of symptoms and the structural abnormality. Some patients improve with physiotherapy and activity modification, while selected patients may require hip preservation surgery.
What is a hip labral tear?
The hip labrum is a ring of tissue around the socket of the hip joint that helps provide stability and contributes to normal joint function.
A labral tear can occur due to injury, repetitive stress or structural abnormalities such as hip impingement.
Treatment depends on the severity of the tear and associated hip problems. Options may include physiotherapy and activity modification or, in selected cases, surgical repair or other hip preservation procedures.
Can hip preservation surgery help avoid hip replacement?
In appropriately selected patients, hip preservation treatment may help maintain the natural hip joint and potentially delay or reduce the need for hip replacement.
However, it is not suitable for every patient and cannot reverse advanced arthritis or severe irreversible joint damage.
A specialist assessment is necessary to determine whether preserving the natural hip is a realistic treatment goal.
Is hip preservation surgery better than hip replacement?
These procedures are designed for different clinical situations. Hip preservation surgery aims to treat a problem while retaining the patient's natural hip joint.
Hip replacement replaces a damaged joint when the natural joint can no longer function adequately.
For a younger patient with a correctable structural problem and healthy enough cartilage, preservation may be considered. For someone with advanced arthritis and extensive joint damage, hip replacement may be more appropriate.
The right treatment depends on the individual patient's condition rather than age alone.
What happens during a hip preservation evaluation?
The evaluation typically includes a detailed discussion of your symptoms, activity limitations, previous treatment and medical history, followed by a physical examination.
Your specialist may recommend imaging such as X-rays, MRI or other investigations to assess the shape of the hip, cartilage, labrum and surrounding structures.
The treatment plan is then based on the underlying cause of the hip problem and the condition of the joint.
How long does recovery take after hip preservation surgery?
Recovery varies according to the type of procedure performed and the patient's individual condition.
Some procedures may allow earlier weight bearing and rehabilitation, while others require a period of protected weight bearing followed by structured physiotherapy.
Your surgeon and physiotherapy team will provide a personalised rehabilitation plan covering weight bearing, mobility, strengthening, return to work and gradual return to sports or other activities.
Why choose Tirupati Trauma Care Centre & Hospital for hip preservation surgery?
Tirupati Trauma Care Centre & Hospital provides specialised orthopaedic evaluation, surgical care and physiotherapy rehabilitation, allowing treatment and recovery to be coordinated according to the patient's needs.
The hospital's trauma and orthopaedic environment is particularly relevant for patients with complex hip injuries and musculoskeletal conditions.
The focus is on accurate diagnosis, appropriate treatment selection, preservation of the natural joint where clinically possible, and structured rehabilitation to help patients regain mobility and function.