Hip osteotomy is a surgical procedure performed to reposition or realign the hip joint by cutting and reshaping the bones around the hip. It is commonly used to treat certain hip conditions, such as hip dysplasia or femoroacetabular impingement (FAI), where there is an abnormal relationship between the hip socket (acetabulum) and the femoral head (ball-shaped top of the thigh bone).
The goal of hip osteotomy is to improve the alignment and mechanics of the hip joint, redistribute forces, relieve pain, and potentially delay or prevent the need for more extensive procedures such as hip replacement.
Here is an overview of the hip osteotomy procedure:
1. Preoperative Assessment:
Before the surgery, the patient undergoes a comprehensive evaluation, including a medical history review, physical examination, and imaging tests such as X-rays, MRI, or CT scans. These assessments help determine the appropriateness of hip osteotomy and plan the procedure accordingly.
2. Anesthesia:
Hip osteotomy is typically performed under general anesthesia, which means the patient is unconscious during the surgery. In some cases, regional anesthesia or a combination of general and regional anesthesia may be used.
3. Incision:
An incision is made over the hip joint to access the bones. The size and location of the incision depend on the specific type of osteotomy being performed.
4. Bone Cutting and Reshaping:
The surgeon carefully cuts and reshapes the bones around the hip joint based on the planned osteotomy technique. There are different types of hip osteotomies, including:
Periacetabular Osteotomy (PAO): In a PAO, the acetabulum is repositioned by cutting the pelvic bone around the socket and then rotating and stabilizing it in a more optimal position.
Femoral Osteotomy: In a femoral osteotomy, the femur is cut and repositioned to improve the relationship between the femoral head and the socket. This can be done in various ways, depending on the specific needs of the patient.
Intertrochanteric Osteotomy: In an intertrochanteric osteotomy, the femur is cut just below the hip joint, and the upper portion of the bone is repositioned to improve alignment and stability.
5. Fixation:
After the bone is reshaped, it is stabilized with screws, plates, or other fixation devices to maintain the corrected position during healing.
6. Closure:
The incision is carefully closed using sutures or staples, and sterile dressings are applied to protect the wound.
7. Postoperative Care and Rehabilitation:
After the surgery, the patient is monitored in a recovery area before being transferred to a hospital room. Pain management, early mobilization, and physical therapy are essential for recovery and rehabilitation. Physical therapy helps restore strength, range of motion, and overall function.
The recovery period following hip osteotomy can vary depending on the specific procedure performed and the individual patient. It may take several months for the bones to heal and for the patient to regain full function and mobility. Rehabilitation and physical therapy play a crucial role in the recovery process to optimize outcomes.
It’s important to note that hip osteotomy is not suitable for everyone. The decision to undergo a hip osteotomy is based on various factors, including the specific hip condition, the severity of symptoms, patient characteristics, and the surgeon’s expertise. An orthopedic surgeon specializing in hip conditions can evaluate your specific case and determine if hip osteotomy is the most appropriate treatment option for you.
As with any surgical procedure, hip osteotomy carries certain risks and potential complications, including infection, blood clots, nerve or blood vessel injury, delayed bone healing, and the need for additional procedures. Your surgeon will discuss these risks with you and provide specific instructions for a successful recovery. At Alabama Bone and Joint Clinic our specialists are able to guide you through your treatment options. Call today to schedule an appointment with one of our experts in orthopedic care.
