Total Hip Arthroplasty after Hip Preservation Surgery Outcomes and Challenges

Hip preservation surgery (HPS) is increasingly performed in young and active patients with the aim of delaying or avoiding total hip arthroplasty (THA). Despite advances in preservation techniques, a proportion of patients eventually progress to end-stage hip disease and require conversion to THA. Performing THA after prior HPS presents unique challenges because of altered anatomy, retained hardware, soft-tissue scarring, and compromised bone quality. This narrative review evaluates the existing literature on THA following various hip preservation procedures, including hip arthroscopy, periacetabular osteotomy, femoral osteotomies, and core decompression. A comprehensive review of PubMed-indexed studies was undertaken to assess indications for conversion, preoperative considerations, intraoperative challenges, surgical strategies, and clinical outcomes.