home
print·home·mail

Hip

back

Hip joint dysplasia and corrective osteotomy

The term hip dysplasia describes changes to the hip joint as the result of congenital or developmental malformation, with increased steepness and decreased depth of the hip socket. This is often also associated with an increased angle between the head and neck of the femur and its shaft (cox valga), with the result that the head of the femur has a tendency to move out of the socket at the top, i.e. it subluxates or luxates out of the socket. Untreated, these misalignments tend to cause early-onset arthroses of the hip joint, which may then necessitate the implantation of total hip endoprostheses.

Therapy

Subluxation and luxation of the femoral head require surgical intervention once all conservative options are exhausted. A distinction is made between operations at the pelvis, which involve procedures known as pelvic osteotomies to improve coverage of the femoral head, and corrective alignments of the femur itself.

  • Pelvic (acetabular) osteotomy: The hip socket as a whole is mobilized and positioned over the femoral head as desired.
  • Femoral osteotomy: If the malalignment cannot be sufficiently rectified by a pelvic osteotomy, an additional corrective osteotomy of the femur is performed.

Aftercare

All repositioning operations are exclusively performed on an in-patient basis. To ensure the best possible outcome of the operation, patients are encouraged to get mobile soon after surgery with the help of a physiotherapist; depending on the osteotomy technique used, only partial weight may be applied to the affected leg for several weeks after surgery. Until the bone is healed, weight-bearing on the operated hip must be kept to 10-20 kg; after that, progression to full load can be swift.

Patients' progress is documented through regular out-patient check-ups at close intervals; if applicable, the weight limit can be raised on the evidence of a radiological alignment check.