(Osteotomy, Hip)
Definition
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, reshape, and reposition the bones of the pelvis or legs.
The Hip JointCopyright © Nucleus Medical Media, Inc.
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Reasons for Procedure
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
Possible Complications
Complications are rare. But no procedure is completely free of risk. The doctor will review a list of possible complications, including:
- Incomplete healing of the bone
- Shortening of the leg
- Bleeding
- Ball cannot be fit into the socket
- Infection
- Reaction to anesthesia
- Blood clots
- Injuries to nerves or blood vessels
- Nausea and vomiting
Before your procedure, talk to your doctor about ways to manage factors that may increase your risk of complications such as:
- Exposure to smoke
- Chronic disease such as diabetes or asthma
What to Expect
What to Expect
Prior to Procedure
Your doctor will do a physical exam.
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 your medications. Some medications may need to be stopped before the surgery.
You may be asked to stop eating or drinking after midnight the night before surgery.
Anesthesia
General anesthesia is usually used. It blocks pain and promotes sleep 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 will be attached to a new area and held in place with plates and screws. The cuts and wedge will allow the shape of the bone to be changed to position them 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
During your stay, the hospital staff will take steps to reduce your chance of infection such as:
- Washing their hands
- Wearing gloves or masks
- Keeping your incisions covered
There are also steps you can take to reduce your chances of infection such as:
- Washing your hands often and reminding visitors and healthcare providers to do the same
- Reminding your healthcare providers to wear gloves or masks
- Not allowing others to touch your incisions
At Home
To help ensure a smooth recovery at home:
- 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
Call Your Doctor
After leaving the hospital, call if there are any of the following:
- 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
In case of an emergency, call for emergency medical services right away.
RESOURCES:
The Arthritis Foundation http://www.arthritis.org
CANADIAN RESOURCES:
References:
http://gait.aidi.udel.edu/procedures/dega_osteotomy.pdf
Accessed March 10, 2015.
Femoral derotational osteotomy. Nemours, Alfred I DuPont Hospital for Children website. Available at:
http://gait.aidi.udel.edu/procedures/femoral_osteotomy.pdf
Accessed March 10, 2015.
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 Updated: 1/27/2014