The hip joint is considered preserved if a biological femoral head is bearing weight and moving in the acetabulum. Muscle, nerve, and bursal problems around the hip joint are included. We will also include Capsular interposition arthroplasty and trochanteric arthroplasty under preservation and consider arthrodesis and femoral head excision procedures as salvage options along with total hip arthroplasty.

Mechanical hip dysfunction includes incongruity, instability, impingement, or abductor dysfunction from morphological variations of the femur and the acetabulum. Hip preservation focuses on biologic reconstruction of the hip joint with arthroscopic and open procedures to restore optimal acetabular and femoral articular surfaces and their interaction. Several procedures like acetabular trimming, neck osteoplasty, labral and capsular repair and reconstruction, sciatic nerve decompression, and excision of heterotopic bone can be done well arthroscopically while most osteotomies of the proximal femur like head reduction, neck osteotomy, neck lengthening, acetabular osteotomies, and capsular interposition arthroplasty are better done with open techniques.