Nonarthroplasty hip surgery for early osteoarthritis

Subtle anatomic abnormalities of the hip, such as acetabular retroversion, acetabular overcoverage, and decreased head-neck offset of the femoral head-neck junction, are important anatomic variants that may lead to pain and osteoarthritis in the young adult population. Advances in surgical techniques, such as the periacetabular osteotomy, safe surgical dislocation of the hip, and hip arthroscopy, are providing us with more effective and safer tools to correct these anatomic problems. The limiting factor in treatment outcome in many mechanically compromised hips is the amount of cartilage damage that has occurred before treatment. This article is a guide to these subtle anatomic abnormalities and the options for treatment.