Hip Osteotomy

A Glimpse into Hip Osteotomy Surgery

A patient with hip displacement or dysplasia may be given the option to undergo a hip osteotomy surgery. This is an alternative surgical procedure to hip replacement surgery that involves reshaping and refitting the patient’s natural bones, as opposed to fitting artificial joints. In this article we are going to explain the hip joint in a bit more detail, then walk you through the basics of the procedure.

The hip is a very practical and impressive joint. The femur (aka: “big bone in the thigh”) connects to the knee area at one end and the hip at the other. The hip-side of the femur is shaped at an angle and round, like a ball. This is known as the femoral head and it fits snugly into the “socket” of the pelvis, medically referred to as the acetabulum. This allows the hips to have a great area of rotation and movement.

An accident or stress to the joint could create the need for osteotomy surgery. Also, many conditions can cause deterioration or hindrance of the hip, such as arthritis or cerebral palsy. In the case of hip dysplasia, the hip bones may actually become misshapen. In older patients with a less active lifestyle, the preferred method of treating the hip is by a hip replacement surgery. If the patient is younger, the doctors will usually recommend a hip osteotomy surgery as it allows the patient to lead a fairly active life and often means less pain.

The surgery itself may seem fairly simple for the patient, as they will be placed under a general anesthetic. The doctor, on the other hand, has at least two and up to five hours of work to look forward to. When the patient is fully anesthetized, the doctor will make an incision to expose the area to be operated on. In basic explanation, the surgeon will trim away the damaged tissues in the socket as well as reshape the femoral head. He will work at both the socket and the head of the femur until they fit well together. He may have to add in some cartilage to serve as padding to support the patient’s weight, as well as a metal pin or plate to keep the bones in the correct position. The incision area will be stitched up and the patient will be moved to a recovery room.

Now, there are two types of osteotomy surgeries that can be performed: Varus Rotational Osteotomy and Pelvic Osteotomy. The type of surgery performed depends on the issue in the patient’s hip. If the patient’s “femoral neck” is too straight or not straight enough, the varus rotational osteotomy will be performed. The surgeon will endeavor to reshape the neck of the femur so that it connects properly with the socket. Sometimes the patient’s hip socket isn’t shaped properly to accommodate the femoral head. In this case, the pelvic osteotomy will be performed. This procedure may require the surgeon to rearrange the cartilage so as to make room for the femoral head; although in some instances bone will be taken from outside of the hip and attached to the socket area to better allow it to accommodate the femoral heal.

The patient will usually be kept in the recovery room for an hour or two where their vitals will be monitored. The patient will usually be kept in the hospital for a week or so for monitoring. They will need to be kept on an IV for the first couple of days to maintain proper fluid levels, as well as to be given antibiotics to prevent infection. The patient will be instructed not to put his/her full weight on the hip for at least eight weeks. It is imperative that the patient gives the hip adequate time to heal and does not attempt activity before the hip is fully recovered.

Hip osteotomy surgery may not be glamorous, but it can mean a world of difference to the patient as far as mobility, freedom, and pain-free moment are concerned!