Type of Surgery
Information
Last updated: 11/24/2009
A hip osteotomy is performed under general anesthesia. Once the patient has been anesthetized, the surgeon makes an incision to expose the hip joint. The surgeon then proceeds to cut away portions of damaged bone and tissue to change the way they fit...
together in the hip joint. This part of the procedure may involve removing bone from the femoral head or from the acetabulum, allowing the bone to be moved slightly within the joint. By changing the position of these bones, the surgeon tries to shift the brunt of the patient's weight from damaged joint surfaces to healthier cartilage. He or she then inserts a metal plate or pin to keep the bone in its new place and closes the incision.
There are different hip osteotomy procedures, depending on the type of bone correction required. Two common procedures are:
- Varus rotational osteotomy (VRO), also called a varus derotational osteotomy (VDO). In some patients, the femoral neck is too straight and is not angled far enough toward the acetabulum. This condition is called femoral neck valgus or just plain valgus. The VRO procedure corrects the shape of the femoral neck. In other patients, the femoral neck is not straight enough, in which case the condition is referred to as a femoral neck varus.
- Pelvic osteotomy. Many hip disorders are caused by a deformed acetabulum that cannot accommodate the femoral head. In this procedure, the surgeon redirects the acetabular cartilage or augments a deficient acetabulum with bone taken from outside the joint.
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An osteotomy is a surgical operation whereby a bone is cut to shorten, lengthen, or change its alignment. It is sometimes performed to correct a hallux valgus, or to straighten a bone that has healed crookedly following a fracture. It is also used to correct a coxa vara, genu valgum, and genu varum. The operation is done under a general anaesthetic.
Two main types of osteotomies are used in the correction of hip dysplasias and deformities to improve alignment/interaction of acetabulum - (socket) - and femoral head (femur head) - (ball), innominate osteotomies and femoral osteotomies. The bones are cut, reshaped or partially removed to realign the load bearing surfaces of the joint.
Adjustments are made to part of the hip-bone. Many operating methods and variations have been developed. They are defined by the type of cut and adjustment made Some acetabular procedures are named after the surgeons who first described them as Salter (R. Salter), Dega (W. Dega), Sutherland (D.H. Sutherland), Chiari (K. Chiari): other names one may encounter are Ludlov, P. Pemberton, and James B. Steele. Some are named after the shape of cut (e.g. Chevron, Wedge) or the way the bones are aligned (Dial=old style rotary dial phone).
Femoral osteotomies, as the name indicates, involves adjustments made to the femur head and/or the femur.
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New procedures like minimally invasive procedures are often subject to scrutiny, but I think that one of the biggest problems facing these innovative procedures is for people to understand exactly what we do.
-Dr. Michael Perry, Laser Spine institute
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