Hip Osteotomy
(Osteotomy, Hip)
Definition
The hip is made of a bowl shape socket on the pelvis and a ball at the top of the leg bone. A hip osteotomy is a surgery to cut and reposition the bones of the pelvis or legs.
The Hip Joint
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Reasons for Procedure
Hip osteotomy is done when the hip bones do not fit together well. Poorly fitting hip bones can cause pain and make it difficult to move. Over a long period of time the improper fit can lead to problems like arthritis.
The surgery is most often done in children. It may be done because of:
- Conditions that cause abnormal muscle contractions such as cerebral palsy
- Hip bones do not form correctly such as in developmental dysplasia of the hip
- Other injuries or illnesses of the hip such as Legg-Calve-Perthes disease
Possible Complications
Complications are rare. But no procedure is completely free of risk. If your child is having an osteotomy, the doctor will review a list of possible complications, including:
- Bleeding
- Reaction to anesthesia
- Infection
- Blood clots
- Nausea and vomiting
- Injuries to nerves or blood vessels
- Shortening of the leg
- Ball cannot be fit into the socket
Discuss these risks with your doctor before surgery.
What to Expect
Prior to Procedure
Your doctor will order imaging tests to help plan the surgery. Images of the hip bones and other structures may be taken with:
In the days leading up to the surgery, the doctor will talk about the medicines you or your child is taking. Some medicines may need to be stopped before the surgery.
You may be saked to stop eating or drinking after midnight the night before surgery.
Anesthesia
General anesthesia is usually used. It blocks pain and keeps you or your child asleep through the surgery.
Description of the Procedure
Several incisions will be made to around the hip joint. The specific bones that are altered will depend on your specific condition. The leg and/or pelvic bones will need to be cut. A wedge of bone may be removed. This wedge may be attached to a new area and held in place with plates and screws. The cuts and wedge will let the doctor reposition the bones into a better place.
The incision area will be closed with stitches.
Immediately After Procedure
Vital signs will be monitored in a recovery room.
How Long Will It Take?
2-5 hours depending on the type of surgery
How Much Will It Hurt?
Anesthesia prevents pain during surgery. Medication will also be given after surgery to help manage pain.
Average Hospital Stay
Hospital stay may last for 4-5 days. Complications will lead to a longer stay.
Post-procedure Care
At the Hospital
Recovery in the hospital may include:
- Pain medication
- Placing and changing bandages over the incision sites
- Using pillow-like devices to separate and support the legs
- Ice to reduce swelling
- Breathing exercises to decrease the risk of fluid build-up in the lungs
At Home
To help ensure a smooth recovery at home:
- Give pain medicine as directed.
- Keep the incision area clean and dry. Care for the wound as instructed by the doctor.
- Ask the doctor when it is safe to shower, bathe, or soak in water.
- You may need to use a walker or wheelchair.
- Follow the instructions the doctor gives you.
A physical therapist can help you with balance, range-of-motion, and strength training.
Your doctor will want to check on your progress. Full recovery can take 3-6 months.
Call Your Doctor
After your child leaves the hospital, contact the doctor if your child has:
- Signs of infection such as fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge around incision site
- Increased pain or swelling
- Cough, shortness of breath, chest pain
- Severe nausea or vomiting
- Numbness, tingling, or loss of feeling in your leg, knee, or foot
- Pain, burning, urgency or frequency of urination, or blood in the urine
In case of an emergency, call for medical help right away.
RESOURCES:
American College of Rheumatology
http://www.rheumatology.org
The Arthritis Foundation
http://www.arthritis.org
CANADIAN RESOURCES:
The Arthritis Society
http://www.arthritis.ca
Health Canada
http://www.hc-sc.gc.ca
REFERENCES:
Dega osteotomy. Nemours, Alfred I DuPont Hospital for Children website. Available at: http://gait.aidi.udel.edu/procedures/dega_osteotomy.pdf . Accessed April 10, 2013.
Femoral derotational osteotomy. Nemours, Alfred I DuPont Hospital for Children website. Available at: http://gait.aidi.udel.edu/procedures/femoral_osteotomy.pdf. Accessed April 10, 2013.
Periacetabular osteotomy. Duke Orthopaedics website. Available at: http://www.dukehea... . Accessed April 10, 2013.
6/6/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed/ : Mills E, Eyawo O, Lockhart I, Kelly S, Wu P, Ebbert JO. Smoking cessation reduces postoperative complications: a systematic review and meta-analysis. Am J Med. 2011;124(2):144-154.e8.
Last reviewed March 2013 by Michael Woods, MD
Last Updated: 4/10/2013
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