There are surgical techniques, commonly termed "Osteochondroplasties or Osteoplasties", which consist of restoring the original shape of the hip, e.g. by removing the "hump" and the "acetabular overcoverage" to restore complete mobility and eliminate femoroacetabular impingement. Specifically, one of the best-accepted surgical techniques in the world is the one developed by our unit and known as the Ribas osteoplasty via minimally invasive approach with a 6-8 cm incision, which is a less aggressive variation of the Ganz Osteoplasty (between 20 and 30 cm). This technique offers great accuracy in restructuring the hip and a much speedier return to physical activity compared to the Ganz osteoplasty technique, which requires an osteotomy of the greater trochanter and dislocation of the hip, whilst the Ribas technique does not require these surgical procedures.

The presentation of our work to American Academy of Orthopaedic Surgeons (AAOS) showed very good clinical results in the first series of 117 patients (currently over 300 patients have been operated on), on over 92% of patients if they were operated on in early stages. When the hip presents greater deterioration, with osteophytes and a reduction in cartilage thickness of no more than 2 mm, the excellent and good results remain at 60%, although there was a subjective perception of improved quality of life in 85% of patients according to the Western Ontario Macmasters (WOMAC) index.

X-rays before (left) and after (right) the osteochondroplasty.  
Limited hip mobility due to femoroacetabular impingement (left in black and white). After the osteochondroplasty (right and in colour) mobility is restored. Dr. Manuel Ribas has developed a now world-renowned minimally invasive osteochondroplasty technique which allows a much speedier return to sporting activities than other modern surgical techniques.  
Left: minimally invasive incision for the Ribas Osteoplasty. Right: this technique also permits the introduction of an arthroscope to examine the lesions on the labrum and repair them.

A third treatment variant, which is increasingly popular, is arthroscopic osteoplasty, visualised via a fibre optic system and two or three arthroscopic incisions of between 10 and 14 mm each. Recovery is very similar to that of the Ribas osteoplasty. Our Arthroscopy Unit, which has Dr. Marc Tey as a specialist in hip arthroscopy, is one of the teams with the greatest experience in Europe in this type of treatment. However, the Hip Unit decides if it is best to perform treatment via the Ribas minimally invasive technique or arthroscopy depending on the type of deformity and its stage.