629517 Health Library | Health and Wellness | Wellmont Health System
  • Hip Osteotomy

    (Osteotomy, Hip)

    Definition

    During a hip osteotomy, the thigh bone (femur) and/or the pelvic bone are cut. The pelvic bone contains the hip socket. This surgery is done to realign the hip socket so that the ball (top of the femur) and socket fit together properly.
    The Hip Joint
    Nucleus factsheet image
    Copyright © Nucleus Medical Media, Inc.

    Reasons for Procedure

    Hip osteotomy is usually done in children. This procedure is done when the ball and socket do not fit together. This can be due to muscles contracting abnormally because of cerebral palsy . It can also be due to a congenital condition called hip dysplasia . The procedure makes the ball align better with the socket so that the hip does not dislocate. The procedure may be done in adults, but it is less common.

    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
    Factors that may increase the risk of complications include:
    Discuss these risks with your doctor before surgery.

    What to Expect

    Prior to Procedure

    Prior to surgery, the doctor will order tests to confirm the diagnosis and decide how much bone needs to be removed. Tests may include:
    • X-rays
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the body
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the body
    • Arthrogram—a contrast dye is injected into the joint and images are taken
    In the days leading up to the surgery, the doctor will:
    • Talk about the medicines your child is taking. Some medicines may need to be stopped before the surgery.
    • Depending on your child’s age, your child may be instructed not to eat or drink after midnight the night before surgery.

    Anesthesia

    General anesthesia is usually used. It blocks pain and keeps your child asleep through the surgery.

    Description of the Procedure

    Depending on your child’s condition, the femur, pelvis, or both will need to be cut. The goal is to realign the hip joint, placing the ball into the socket correctly.
    The doctor will use imaging technology to locate the piece of bone that will be removed. Several incisions will be made to access the hip joint. A wedge of bone will be cut. After the wedge is taken out, metal plates and screws will hold the bones in their new position. The incision area will be closed with stitches. The doctor may also need to lengthen the muscles in the groin area.

    Immediately After Procedure

    Your child will stay in the recovery room for a couple of hours. The nurses will monitor his vital signs. Your child may be given pain medicine through a vein in his arm.

    How Long Will It Take?

    2-5 hours depending on the type of surgery

    How Much Will It Hurt?

    Anesthesia prevents pain during surgery. The doctor will give your child pain medicine after surgery.

    Average Hospital Stay

    Your child may need to stay in the hospital for 4-5 days. If there are any problems, he will need to stay longer.

    Post-procedure Care

    At the Hospital
    While your child is recovering in the hospital, the staff may:
    • Give pain medicine
    • Place padded bandages over the incision sites
    • Place a pillow-like device between your child’s legs to separate them
    • Apply ice to reduce swelling
    • Have your child breathe deeply and cough 10-20 times every hour to decrease the risk of fluid build-up in the lungs
    Your child may need to use a walker or a wheelchair.
    At Home
    When your child returns home, do the following to help ensure a smooth recovery:
    • Give pain medicine as directed.
    • Keep the incision area clean and dry. Care for the wound as instructed by the doctor.
    • Ask the doctor about when it is safe for your child to shower, bathe, or soak in water.
    • Your child may have to use a walker.
    • Follow the instructions the doctor gives you.
    Your child will work with a physical therapist. The therapist will focus on balance, range-of-motion, and strength training.
    Your child will need to return to the doctor to have x-rays taken. 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 (eg, fever, 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/index%5Fe.html/

    References

    Carson-DeWitt R. Spinal and epidural anesthesia. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 20, 2010. Accessed November 23, 2010.

    Dega osteotomy. Nemours, Alfred I DuPont Hospital for Children website. Available at: http://gait.aidi.udel.edu/procedures/dega%5Fosteotomy.pdf . Accessed November 23, 2010.

    Femoral derotational osteotomy. Nemours, Alfred I DuPont Hospital for Children website. Available at: http://gait.aidi.udel.edu/procedures/femoral%5Fosteotomy.pdf . Accessed November 23, 2010.

    Kellicker P. Hip replacement. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated September 20, 2010. Accessed November 23, 2010.

    Osteoarthritis. EBSCO Health Library website. Available at: http://www.ebscohost.com/healthLibrary/ . Updated November 15, 2010. Accessed November 23, 2010.

    Osteotomy. Cedars-Sinai website. Available at: http://www.cedars-sinai.edu/Patients/Programs-and-Services/Orthopaedic-Center/Treatment/Osteotomy.aspx . Accessed November 23, 2010.

    Periacetabular osteotomy. Duke Orthopaedics website. Available at: http://www.dukehealth.org/orthopaedics/services/hip-treatments/treatments/periacetabular-osteotomy . Accessed November 23, 2010.

    6/6/2011 DynaMed's Systematic Literature Surveillance DynaMed's Systematic Literature Surveillance : 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.

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