joint. The "ball part of the joint is the top part of your thigh bone. The "socket" is a part of your pelvic bone. The ball fits into a groove called the acetabulum. These bones fit together and are called the hip joint. Normally, these parts fit together tightly. If these parts do not fit together right, surgery may be needed to fix the problem. ‚
A hip osteotomy is a procedure to realign the hip joint. This is more often done in teenagers and young adults. They may have problems with hip alignment because of: ‚
- Trauma or injury
- Being born with a problems where the hip bones do not line up
- A problem with poor blood supply to the hip causes bone death. This is avascular necrosis.
- Cerebral palsy
- Legg-Calve Perthes disease
People of all ages with mild arthritis may benefit from this procedure. It is sometimes done instead of a hip replacement surgery. ‚
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What will the results be?
Your hip joint will be realigned. After the surgery you may have less pain and less problems walking. ‚
What happens before the procedure?
- Your doctor will take your history. Talk to your doctor about:
- All the drugs you are taking. Be sure to include all prescription and over-the-counter (OTC) drugs, and herbal supplements. Tell the doctor about any drug allergy. Bring a list of drugs you take with you.
- Any bleeding problems. Be sure to tell your doctor if you are taking any drugs that may cause bleeding. Some of these are Coumadin ‚ ®, ibuprofen, Aleve ‚ ® (naproxen), or aspirin. Certain vitamins and herbs, such as garlic and fish oil, may also add to the risk for bleeding. You may need to stop these drugs as well. Talk to your doctor about them.
- When you need to stop eating or drinking before your procedure.
- Your doctor will do an exam and may order:
- Lab tests
- X-ray
- Ultrasound
- CT or MRI scan
- Your doctor may tell you to do stretching exercises weeks before the operation. This will aid in recovery after the procedure.
- You will not be allowed to drive right away after the procedure. Ask a family member or a friend to drive you home.
What happens during the procedure?
- Once you are in the operating room, you will be given a drug to make you sleepy. It will also help you stay pain free during the surgery. The staff will put an I.V. in your arm to give you fluids and drugs.
- Monitors will keep track of your blood pressure and heart rate. Your doctor will clean your buttocks and apply an antiseptic.
- Your doctor will make a cut on the outside of your buttocks. Your doctor will locate the head of your thigh bone.
- Your doctor will make cuts on the surface of your thigh bone or hip socket until the bones fit together. Your doctor may twist the bones around to make the bones fit. Your doctor may use a metal plate or pin to hold the bones in place.
- Your doctor will test the movement of your hip joint. When your doctor is satisfied with how your bones are lined up, the area will be flushed with cleansing fluid.
- Your doctor will close your cut with stitches or staples and cover it with clean bandages.
- The procedure takes about 2 to 5 hours.
What happens after the procedure?
- You will go to the Recovery Room and the staff will watch you closely. You may have to stay in the hospital for a few days to a week.
- Within a day or two, you will get out of bed to a chair. The staff will help you begin to walk around. Doing coughing and deep breathing exercises will help keep your lungs clear. You will get drugs to help with your pain.
- Your doctor may have you wear special stockings to prevent blood clots. You will be given these stockings in the hospital.
- The nurse will help put pillows or cushions around or under your legs to position your hips.
What care is needed at home?
- Ask your doctor what you need to do when you go home. Make sure you ask questions if you do not understand what the doctor says. This way you will know what you need to do.
- Your doctor will give you drugs for pain and to prevent infection. Make sure to take all the drugs ordered by your doctor.
- Your doctor may give you drugs to prevent blood clots in the legs. Take these as ordered by your doctor.
- Your doctor may put a body cast on you. Talk to your doctor about how to care for your cast. Keep the cast clean and dry.
- Avoid putting weight on the newly operated hip joint for 8 to 10 weeks. You will learn to walk with a walker or crutches while your hip heals. You may also need a wheelchair.
- Place an ice pack or a bag of frozen peas wrapped in a towel over the painful area of the hip. Never put ice directly on the skin. Do not leave the ice on more than 10 to 15 minutes at a time.
- Prop your leg on a pillow when sitting or resting in bed.
- Talk to your doctor about how to care for your cut site. Ask your doctor about:
- When you should change your bandages
- When you may take a bath or shower
- If you need to be careful with lifting things over 10 pounds
- When you may go back to your normal activities like work, driving, or sex
- Be sure to wash your hands before touching your wound or dressing.
What follow-up care is needed?
- Your doctor may ask you to make visits to the office to check on your progress. Be sure to keep these visits.
- If you have stitches or staples, you will need to have them taken out. Your doctor will often want to do this in 1 to 2 weeks.
- You may also need to see a physical therapist (PT). The PT will teach you exercises to help you get back your strength and motion. It may take 4 to 6 months before you can walk without using a walker or crutches.
- Your doctor may set an office visit to take off your body cast after 1 to 2 months.
What lifestyle changes are needed?
- Your doctor will give you a card that lets people know you have metal hardware inside your hips. Keep this card with you always, especially when you go to airports and buildings with metal detectors.
- Keep a healthy weight. Being overweight puts extra stress on your hips and may affect healing.
What problems could happen?
- Blood clots
- Infection
- Hip joint might not heal correctly
- Allergic reaction to metal plates and screws
- Injury to nerves or blood vessels
- One leg may be shorter than the other after surgery
When do I need to call the doctor?
- Signs of infection. These include fever of 100.4 ‚ °F (38 ‚ °C) or higher, chills, pain with passing urine, wound that will not heal.
- Signs of wound infection. These include swelling, redness, warmth around the wound; too much pain when touched; yellowish, greenish, or bloody discharge; foul smell coming from the cut site; cut site opens up.
- Pain in the leg, especially in the back of the calf muscle or a sudden increase in swelling in the leg. This could be a sign of a blood clot. Call your doctor right away.
- Very bad upset stomach or throwing up
- Health problem is not better or you are feeling worse
Helpful tips
- Do not cross your legs or raise your knee higher than your hips for about 8 to 10 weeks after the procedure.
- If your toilet is too low when you sit, get a special raiser that can raise the toilet seat.
Where can I learn more?
International Hip Dysplasia Institute ‚
http://www.hipdysplasia.org/developmental-dysplasia-of-the-hip/child-treatment-methods/osteotomy/ ‚
http://www.hipdysplasia.org/adult-hip-dysplasia/adult-treatments/hip-preservation-surgery-for-adult-hip-dysplasia/ ‚
National Institute of Arthritis and Musculoskeletal and Skin Diseases ‚
http://www.niams.nih.gov/Health_Info/Hip_Replacement/default.asp ‚
Consumer Information Use and Disclaimer
This information is not specific medical advice and does not replace information you receive from your health care provider. This is only a brief summary of general information. It does NOT include all information about conditions, illnesses, injuries, tests, procedures, treatments, therapies, discharge instructions or life-style choices that may apply to you. You must talk with your health care provider for complete information about your health and treatment options. This information should not be used to decide whether or not to accept your health care providers advice, instructions or recommendations. Only your health care provider has the knowledge and training to provide advice that is right for you. ‚
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Copyright ‚ © 2015 Clinical Drug Information, LLC and Lexi-Comp, Inc. ‚