Acetabuloplasty: Definition, Uses, and Clinical Overview

Posted on February 27, 2026 | by drhip

Acetabuloplasty Introduction (What it is)

Acetabuloplasty is a hip-preservation procedure that reshapes part of the acetabulum, the socket of the hip joint.
In plain terms, it adjusts the socket’s bony edge to improve how the ball-and-socket joint fits and moves.
It is most commonly discussed in the context of hip arthroscopy and femoroacetabular impingement (FAI).
Depending on the clinical goal, it may reduce excess socket coverage or help optimize socket shape during corrective hip surgery.

Why Acetabuloplasty used (Purpose / benefits)

The hip is a ball-and-socket joint: the femoral head (ball) moves within the acetabulum (socket). For smooth motion, the ball and socket need an appropriate shape, adequate—but not excessive—coverage, and healthy cartilage and labrum.

Acetabuloplasty is used when the acetabular rim (the socket’s edge) contributes to pain or mechanical symptoms because of abnormal contact between the socket and the femur. One common scenario is pincer-type femoroacetabular impingement, where the socket covers the femoral head too much or in an unfavorable pattern. During hip motion—often hip flexion and rotation—this can cause repetitive contact that irritates the labrum and may contribute to cartilage injury.

At a high level, the goals of Acetabuloplasty may include:

Reducing abnormal bony contact to improve hip mechanics during movement.
Protecting or addressing soft-tissue injury, especially the labrum (a ring of fibrocartilage that seals and stabilizes the joint).
Improving symptoms such as groin pain, catching, pinching, clicking, or activity-related discomfort (symptoms vary by clinician and case).
Supporting hip preservation, meaning efforts to relieve symptoms and improve function while delaying or avoiding joint replacement in appropriately selected patients (outcomes vary by clinician and case).

Benefits are typically framed around improved motion tolerance and reduced impingement-related pain, but results depend heavily on underlying anatomy, cartilage health, and the completeness of diagnosis.

Indications (When orthopedic clinicians use it)

Acetabuloplasty is considered in situations such as:

Imaging and exam findings consistent with pincer FAI or mixed FAI (pincer plus cam features).
Persistent hip pain with mechanical symptoms (for example, pinching with flexion) that correlates with acetabular rim overcoverage on imaging.
Labral pathology (labral tear or degeneration) where acetabular rim shape is believed to contribute to labral overload.
Focal acetabular rim prominence (including certain patterns like acetabular retroversion) when deemed clinically relevant.
As part of a broader hip arthroscopy plan that may also include femoroplasty (reshaping the femoral head-neck junction), labral repair, or chondral (cartilage) procedures.
Selected pediatric or adolescent hip disorders may use the term “acetabuloplasty” to describe socket-shaping pelvic procedures; exact indications and techniques differ by age and diagnosis (varies by clinician and case).

Contraindications / when it’s NOT ideal

Acetabuloplasty is not suitable for every hip problem, and clinicians may recommend other approaches when:

Advanced hip osteoarthritis is present, particularly with significant joint-space narrowing or diffuse cartilage loss (hip arthroscopy procedures often have less predictable benefit in this setting; varies by clinician and case).
Significant hip dysplasia (insufficient socket coverage/instability) is the main issue; rim trimming could worsen coverage and instability, and a different reconstructive approach may be considered.
Hip pain is not primarily mechanical or intra-articular, such as pain driven mainly by lumbar spine pathology, certain tendon disorders, or systemic inflammatory disease (diagnosis-dependent).
Active infection, unaddressed medical instability, or other surgical risk factors make elective hip preservation surgery inappropriate.
The patient cannot participate in the expected follow-up and rehabilitation pathway (requirements vary by clinician and case).
Imaging suggests a different primary pain generator (for example, fracture, tumor, or avascular necrosis), where acetabuloplasty does not address the root problem.

How it works (Mechanism / physiology)

Biomechanical principle: Acetabuloplasty changes how the rim of the acetabulum interacts with the femoral head-neck junction during motion. In pincer-type impingement, the acetabular rim may contact the femur too early in the arc of motion, creating a “levering” effect that can stress the labrum and pinch cartilage.

Anatomy involved:

Acetabulum (socket): A concave structure formed by parts of the pelvis. The rim is the bony edge that helps define coverage of the femoral head.
Femoral head and neck (ball region): The shape and offset of the head-neck junction influence clearance during hip flexion and rotation.
Labrum: A fibrocartilage ring attached near the acetabular rim that contributes to stability and joint sealing (fluid pressurization).
Articular cartilage: Smooth lining on both the femoral head and acetabulum; cartilage health strongly influences symptoms and long-term outcomes.
Hip capsule and surrounding muscles: Provide stability and control; surgical approaches may include capsular management that can affect postoperative stability and stiffness (varies by technique).

What “onset/duration” means here: Acetabuloplasty is a structural (bony) modification. It is not temporary in the way a medication effect is. The bony reshaping is intended to be durable, but symptom improvement and longevity depend on cartilage status, underlying morphology, activity demands, and rehabilitation—so outcomes vary by clinician and case. “Reversibility” does not apply in a simple way because removed bone is not typically restored; however, additional procedures may be considered if symptoms persist or if the diagnosis changes.

Acetabuloplasty Procedure overview (How it’s applied)

Acetabuloplasty is a surgical intervention rather than a medication or device application. It is most commonly performed arthroscopically (through small incisions with a camera), though open approaches may be used in specific contexts.

A general, high-level workflow often looks like this:

Evaluation / exam – Clinical history focused on motion-related hip or groin pain, mechanical symptoms, and activity limitations. – Physical exam including impingement maneuvers and assessment of hip range of motion. – Imaging typically includes X-rays; MRI (often MR arthrography) may be used to evaluate labrum/cartilage; CT may be used for detailed bony morphology in select cases (varies by clinician and case).
Preparation – Surgical planning to determine whether acetabular rim reshaping is needed and how it fits with other planned procedures (for example, femoroplasty or labral repair). – Discussion of expected goals and limitations, including the influence of cartilage damage on outcomes.
Intervention – Access to the hip joint via arthroscopy or an open technique. – Identification of acetabular rim morphology contributing to impingement. – Controlled reshaping of the rim (rim trimming) while aiming to preserve or restore labral function (often paired with labral repair or reconstruction when indicated; varies by clinician and case).
Immediate checks – Intraoperative assessment of hip motion and clearance after reshaping. – Confirmation of labral stability/seal and evaluation of cartilage surfaces.
Follow-up – Postoperative visits to monitor healing, symptoms, and progression through rehabilitation. – Imaging may be used selectively to evaluate bony correction or rule out complications (varies by clinician and case).

This overview intentionally avoids step-by-step surgical instruction; exact techniques and protocols vary.

Types / variations

“Acetabuloplasty” may refer to different but related concepts depending on patient age, diagnosis, and surgical setting.

Common variations include:

Arthroscopic acetabuloplasty (rim trimming) for pincer FAI
Focuses on reducing focal or global overcoverage at the acetabular rim.
Frequently combined with labral repair and, in mixed FAI, femoroplasty.
Open acetabuloplasty
Less common in routine FAI care but may be used in complex anatomy, revision settings, or when combined with other open hip preservation procedures (varies by clinician and case).
Acetabuloplasty concepts in pediatric/adolescent hip surgery
In pediatric orthopedics, some pelvic procedures aim to reshape or reorient the acetabulum to improve coverage in developmental dysplasia of the hip (DDH). These are often described more specifically by osteotomy name rather than the generic term “acetabuloplasty.”
Indications, goals, and risks differ substantially from adult FAI surgery.
Therapeutic combination procedures
Acetabuloplasty may be part of a “package” approach: addressing bony morphology, labral integrity, cartilage lesions, and capsular stability together. The mix of procedures is individualized (varies by clinician and case).

Pros and cons

Pros:

Can address a structural contributor to impingement by reshaping acetabular rim morphology.
Often performed with minimally invasive arthroscopy, which may reduce soft-tissue disruption compared with larger open exposures (case-dependent).
Commonly paired with labral preservation strategies (repair/reconstruction) to support hip joint function.
May improve hip motion tolerance by reducing painful bony contact (symptom response varies).
Fits within a broader hip preservation framework when arthritis is limited and anatomy is correctable (varies by clinician and case).

Cons:

Not a good match for pain driven primarily by advanced cartilage loss/arthritis, where improvement may be limited (varies by clinician and case).
As with any surgery, carries risks such as infection, blood clots, nerve irritation, stiffness, persistent pain, or need for additional procedures (risk profile varies by patient and technique).
Over- or under-correction can occur, potentially leaving symptoms unresolved or affecting stability (risk varies by surgeon experience and anatomy).
Recovery commonly involves rehabilitation and temporary activity limits, which may be disruptive for work or sports.
Outcomes depend heavily on accurate diagnosis and identifying all contributing factors (spine, soft tissues, femoral shape, cartilage health).

Aftercare & longevity

Aftercare following Acetabuloplasty generally centers on protecting healing tissues, restoring motion and strength, and progressively returning to daily activities and sport as tolerated under clinician supervision. The exact plan (including weight-bearing status, range-of-motion limits, and therapy milestones) varies by clinician and case.

Factors that commonly influence recovery experience and durability of results include:

Severity and type of underlying morphology (focal versus more global overcoverage; mixed FAI).
Cartilage health at the time of surgery, since cartilage damage can affect symptom persistence and long-term joint function.
Labral management (for example, repair versus reconstruction) and how well the labrum can contribute to the joint seal afterward (varies by tissue quality).
Capsular management and hip stability, especially in patients with generalized laxity or borderline dysplasia features (varies by clinician and case).
Rehabilitation participation and progression, including rebuilding hip and core strength and movement control.
Activity demands and biomechanics, such as repetitive deep flexion/rotation in certain sports or occupations.
Comorbidities that affect healing and conditioning (for example, metabolic disease, smoking status, or other joint problems).
Revision risk and long-term joint trajectory, which may include future procedures in some patients; in others, symptoms may remain improved for extended periods (varies by clinician and case).

Longevity is not a single number for everyone. Clinicians often describe results in terms of symptom control and function over time, with the understanding that hip joint degeneration—if present—may still progress.

Alternatives / comparisons

The right comparison depends on the diagnosis driving symptoms (impingement, dysplasia, arthritis, tendon problems, or referred pain). Common alternatives clinicians may discuss include:

Observation and activity modification
For mild symptoms or uncertain diagnosis, monitoring and adjusting provoking activities may be considered. This does not change bony anatomy, but it may reduce symptom triggers for some people.
Physical therapy and rehabilitation-based care
Often used as first-line management for non-urgent hip pain. Therapy may focus on hip and trunk strength, movement patterns, and mobility. It does not reshape bone, but it can improve control and reduce irritability in some cases (response varies).
Medications
Non-opioid pain relievers or anti-inflammatory medications may be used to manage symptoms. They do not correct impingement morphology and are typically considered supportive rather than definitive for structural causes.
Injections
Intra-articular injections may be used diagnostically (to clarify whether pain is coming from inside the joint) and/or therapeutically to reduce inflammation for a period of time. Duration and response vary by medication type and individual factors.
Femoroplasty (for cam-type FAI)
If the primary driver is femoral head-neck shape, reshaping the femur may be emphasized. Many patients with FAI have mixed morphology and may undergo both femoroplasty and acetabuloplasty (varies by case).
Periacetabular osteotomy (PAO) or other reconstructive procedures
In acetabular dysplasia or instability-driven pain, procedures that reorient the socket may be considered instead of rim trimming. These are different operations with different goals and recovery profiles.
Total hip arthroplasty (hip replacement)
For advanced arthritis, replacement may provide more predictable relief than hip preservation approaches. The decision is individualized and depends on imaging, symptoms, and functional goals (varies by clinician and case).

Acetabuloplasty Common questions (FAQ)

Q: Is Acetabuloplasty the same as hip arthroscopy?
Acetabuloplasty is not the same thing as hip arthroscopy, but it is often performed during hip arthroscopy. Hip arthroscopy describes the minimally invasive approach to access the joint. Acetabuloplasty describes a specific step: reshaping part of the acetabular rim.

Q: What conditions is Acetabuloplasty most commonly used for?
It is most often associated with pincer-type femoroacetabular impingement and some mixed FAI cases. The goal is to reduce abnormal socket-to-femur contact that can irritate the labrum and cartilage. Exact indications vary by clinician and case.

Q: How painful is recovery after Acetabuloplasty?
Pain experience varies widely based on the procedures performed alongside acetabuloplasty (for example, labral repair) and individual factors. Many patients report soreness and stiffness early on, with gradual improvement as healing and rehabilitation progress. Clinicians typically use a multimodal pain-control plan tailored to the patient.

Q: How long do results last?
Because Acetabuloplasty involves bony reshaping, the structural change is intended to be durable. However, symptom relief and function over time depend on cartilage health, biomechanics, activity demands, and whether arthritis is present. Longevity therefore varies by clinician and case.

Q: What are the main risks or complications?
Risks can include infection, blood clots, nerve irritation or numbness, stiffness, persistent pain, heterotopic ossification (bone forming in soft tissue), and the possibility of additional surgery. The likelihood of specific complications varies by patient health, anatomy, and surgical technique. Discussing individualized risk is part of preoperative planning.

Q: Will I be non-weight-bearing after Acetabuloplasty?
Postoperative weight-bearing status depends on what was done during surgery and the surgeon’s protocol. Some patients are allowed partial or protected weight bearing for a period, especially if additional cartilage or labral procedures were performed. Exact instructions vary by clinician and case.

Q: When can someone drive or return to work?
Timing depends on the side of surgery, pain control, mobility, medication use, and the type of work (desk-based versus physical). Driving is typically delayed until a person can safely control the vehicle and is not impaired by medications, but the timeline varies. Work return is similarly individualized.

Q: Is Acetabuloplasty used for hip dysplasia?
In adult hip preservation, dysplasia is more often treated with procedures that reorient the socket rather than trimming the rim, because rim trimming can reduce coverage and potentially worsen instability. In pediatric orthopedics, the term “acetabuloplasty” may be used differently to describe socket-shaping procedures aimed at improving coverage. The appropriate approach depends on age, anatomy, and diagnosis.

Q: How is Acetabuloplasty different from femoroplasty?
Acetabuloplasty reshapes the acetabular rim (socket side). Femoroplasty reshapes the femoral head-neck junction (ball side), commonly for cam-type impingement. Many symptomatic hips have mixed features, so clinicians may address both areas in the same operation (varies by case).

Q: Does Acetabuloplasty prevent arthritis?
It is often performed with the intent of improving mechanics and reducing impingement-related damage, but it does not guarantee that arthritis will be prevented. If cartilage injury is already present, degeneration may still progress over time. Outcomes and long-term joint health vary by clinician and case.