A High-Risk Surgery for the Incurable: Osteotomy for Hip Dysplasia
Osteotomy is a type of surgery that involves cutting and shaping of the bones to help better align and function. Osteotomy may provide substantial relief for hip dysplasia, a condition in which the hip socket is too shallow to properly support the ball of the hip joint. It’s particularly helpful for younger patients, which means not only will the surgery release discomfort and bring stability back to the joint, it may allow them to delay or avoid osteoarthritis. Osteotomy can greatly increase movement and quality of life by placing the bones in such a way that weight is evenly transferred across the joint. The NHS offers a useful guide to treatment pathways.
What is Hip Dysplasia?
Hip dysplasia, or developmental dysplasia of the hip (DDH), is a condition where the hip joint doesn’t develop correctly, producing a poorly fitting joint. Misalignment like this can cause pain, lack of movement, and an unstable feeling—particularly during activities like running, squatting, or jumping. Although some patients are identified in the first year of life, they may not come to clinical attention until early adulthood because symptoms interfere with daily life. If not treated, hip dysplasia may cause cartilage to wear away faster than it can be replaced, eventually leading to osteoarthritis. Osteotomy is a procedure that may be advised before the joint becomes damaged, and can serve as a preventive measure against more invasive treatments such as hip replacement.
Understanding Osteotomy: Types and Purpose
Osteotomy is a complex surgical procedure to correct abnormal anatomy around the hip. The surgeon attempts to reposition the bones by cutting them, so as to help the joint to function and look as good as possible. Two main types of osteotomy are used for the treatment of hip dysplasia:
- PAO (Periacetabular Osteotomy): This addresses the acetabulum or hip socket. It covers more of the femoral head for greater joint stability.
- Femoral Osteotomy: The upper part of the thigh bone (femur) is cut and realigned to help the ball in the hip line up better with the socket.
Both techniques are tailored to the patient’s anatomy and act to reposition weight across the joint, removing the pressure and preventing additional degeneration. Although bimaxillary osteotomy is used in surgical settings, it is a jaw surgery, not a hip surgery.
Who Needs an Osteotomy for Hip Dysplasia?
Good candidates for hip osteotomy are usually young adults who have hip pain, lack of hip movement, or hip instability with little in the way of arthritis. These people may not have recently been responsive to conservative treatments such as physiotherapy, activity modification, or analgesics. Early surgery is the key—by fixing the issue before there’s substantial damage to the cartilage, patients can avoid or delay the time in the not-too-distant future when the joint is too far gone and a full hip replacement is necessary. Diagnosis is usually through complex imaging and examination as listed in NHS guidance.
The Osteotomy Surgery Process
Patients are imaged in detail—with X-rays or MRI scans—prior to surgery to map out the hip structure and identify the best surgical approach. During the procedure:
- The surgeon carefully removes portions of bone (osteotomy) to move and divide the bone.
- The bone is then held in the corrected position with metal screws or a metal plate to allow proper healing.
Patients are typically hospitalised for several days after surgery. Crutches or some type of walking assistance is frequently necessary for 6 to 12 weeks until the bone heals. Physiotherapy starts early to help keep muscles strong and joints flexible. As with any surgery, osteotomy presents some risks, including infection, nerve damage, and failure of the bone to fully heal, but these are rare under experienced care.
Recovery and Rehabilitation After Osteotomy
Osteotomy healing is a long and arduous process. During the first stage, patients are advised to reduce load on the operated hip and to control their pain. Physiotherapy is vital for regaining strength, improving range of motion, and preventing stiffness. Afterward, most people gradually return to normal activities, although recovery may take 6 to 12 months. Follow-up visits also provide the means to measure progress of healing and to alter treatment if necessary. Many patients experience long-term relief and improved mobility with regular treatments.
Conclusion
Hip osteotomy is a reconstructive surgical technique that can restore dysplasia, relieve chronic pain, and postpone the time to total hip joint arthroplasty in young adult patients. It provides a permanent solution to a condition which, if not properly treated, may cause severe, painful arthritis. Do not wait if you are suffering from hip pain or have been diagnosed with hip dysplasia—consult with a specialist to see if osteotomy may be right for you. For more information, visit the NHS website.
Book a consultation today to learn how osteotomy can help you live more comfortably and actively – Chase Lodge Hospital.
