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Hip Osteotomy Specialist
Hip osteotomy is a surgical procedure predominantly used to treat hip dysplasia.
- Are your symptoms affecting your quality of life? Consult our MOH-accredited hip osteotomy specialist for a comprehensive diagnosis of your condition & a personalised treatment plan.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
What is Hip Osteotomy?
Hip osteotomy is a surgical procedure predominantly used to treat hip dysplasia. This condition arises from a deformity in the acetabulum, the socket part of the hip joint. In hip dysplasia, the acetabulum is not deep enough to securely hold the femoral head, the ball portion of the joint.
During a hip osteotomy, a surgeon reorients the acetabulum over the femoral head. This repositioning aims to provide relief from symptoms and preserve the natural hip joint by improving its alignment and function.
Reasons for Hip Osteotomy
Hip osteotomy is typically considered in the following situations:
- Severe Hip Dysplasia
The procedure is recommended for patients with severe hip dysplasia. The discomfort and limitations imposed can be considerable for those with the condition, affecting daily activities and overall well-being. - Failure of Non-Surgical Treatments
If non-surgical approaches fail to provide adequate symptom relief or halt the progression of the condition, a hip osteotomy may be considered. - Skeletal Maturity Without Advanced Osteoarthritis
The procedure is most beneficial for patients who have reached skeletal maturity but do not yet have advanced osteoarthritis. In such cases, hip osteotomy can slow the deterioration of cartilage and labrum in the hip, potentially delaying or even avoiding the need for a hip replacement in the future.
Planning for Hip Osteotomy
The planning phase for a hip osteotomy is comprehensive and typically involves the following:
- Diagnostic Imaging: Before the surgery, X-rays, MRI, and CT scans are conducted to confirm the diagnosis and assess the severity of hip dysplasia.
- Medical Assessment: Patients may need to consult an anaesthetist to evaluate their overall medical condition. This assessment often involves blood tests, a chest X-ray, and an electrocardiogram to determine fitness for surgery.
- Pre-surgical Lifestyle Preparations: Before surgery, patients may need to discontinue certain medications, such as blood thinners and traditional medicine, to minimise surgical risks. Medical conditions should be managed and weight loss can be considered to reduce stress on the operated hip. Planning for post-surgical home care, such as arranging for assistance and installing supportive fixtures like handrails, is also necessary.
- Anesthesia: The surgery is commonly performed under general anaesthesia, potentially supplemented with local anaesthetic injections to reduce pain. The hip surgeon will determine the most suitable method based on each case.
Surgical Procedure
The hip osteotomy involves a series of carefully executed steps:
- Incision and Access
Initially, the orthopaedic surgeon makes an incision to gain access to the pelvis. - Bone Repositioning
Specialised instruments are then used to make precise cuts in the bone. This allows for the repositioning of the acetabulum so that it adequately covers the femoral head. - Joint Preservation
This repositioning can aid the healing of any torn labrum or cartilage, preventing further joint damage. - Securing the New Position
Following the repositioning, screws are placed in the bones to stabilise the newly aligned structure. - Bone Formation
New bone formation occurs across the cut surfaces during the healing process, securing the repositioned acetabulum. This ensures proper alignment of the hip joint’s ball and socket.
In some cases, additional procedures such as a femoral osteotomy may be required to correct misalignment of the femur. Hip arthroscopy might also be performed alongside hip osteotomy to repair damaged labrum or cartilage.
Throughout the procedure, X-ray guidance is used to ensure accurate bone cuts and optimal coverage and alignment of the hip joint.
The procedure usually takes three to four hours.
Benefits of Hip Osteotomy
Hip osteotomy offers several benefits, particularly for individuals with hip dysplasia:
Improved Joint Function |
By realigning the hip joint, the procedure enhances joint function, providing relief from discomfort and improving mobility. |
Preservation of Natural Hip Joint |
The surgery aims to preserve the natural hip joint, which can be preferable to joint replacement, especially in younger patients. |
Reduced Progression of Joint Damage |
By correctly aligning the hip, the surgery slows down the progression of damage to the cartilage and labrum in the hip. This can be particularly beneficial in delaying the onset of arthritis. |
Potential Delay of Hip Replacement |
In many cases, hip osteotomy can delay or even avoid the necessity for a hip replacement later in life. This is especially advantageous for patients who have not yet developed advanced osteoarthritis. |
Possible Complications of Hip Osteotomy
Like any surgical procedure, hip osteotomy carries certain risks and potential complications:
- Bleeding and Infection: As an open surgery, there is a small risk of bleeding and infection at the surgical site.
- Nerve and Blood Vessel Damage: The surgery could potentially cause damage to surrounding nerves and blood vessels. This might result in temporary numbness, which usually recovers spontaneously.
- Blood Clots: There is a risk of blood clots forming in the veins, a common concern with many surgical procedures.
- Anaesthesia Risks: Complications related to anaesthesia, although rare, can occur.
Recovery and Outlook
Recovery from a hip osteotomy involves several stages:
- Pain Management: Postoperative pain is expected, but medications are prescribed for short-term pain relief. Common medications include paracetamol, non-steroidal anti-inflammatory drugs, and opioids.
- Avoiding Surgical Complications: Blood thinning medication may be recommended to reduce the risk of blood clots.
- Mobility Aids: Patients will typically use crutches for six to eight weeks post-surgery. This aids in gradually increasing weight-bearing activities as per the hip surgeon’s instructions. Rehabilitation through physical therapy can also improve joint strength and movement, to slowly reduce reliance on these walking aids.
Most patients can return to work approximately three months after surgery. Resuming sports activities may take between six to 12 months, depending on individual recovery rates.
The long-term outlook following a hip osteotomy is generally positive, with the procedure improving joint function and quality of life, and potentially delaying the need for hip replacement surgery.
Dr Poh Seng Yew
MBBS
MRCSEd
MMED (Ortho)
FRCSEd
With over 18 years of experience, Dr Poh Seng Yew is an orthopaedic surgeon specialising in hip, knee, shoulder and elbow surgery, sports medicine, and trauma surgery.
- Former Director of Sports Service, Department of Orthopaedic Surgery, Singapore General Hospital
- Clinical Hip and Sports Medicine Fellow, Orthopädische Chirurgie München (OCM), Germany
- Fellow, Royal College of Surgeons of Edinburgh, FRCSEd (Orthopaedic Surgery)
- Master of Medicine (Orthopaedic Surgery), National University of Singapore
- Member, Royal College of Surgeons of Edinburgh (MRCSEd)
- Bachelor of Medicine, Bachelor of Surgery (MBBS), National University of Singapore
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Weekdays: 9.00am – 5.00pm
Saturdays: 9.00am – 1.00pm
Sundays and Public Holidays: Closed
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Mount Elizabeth Novena Specialist Centre
38 Irrawaddy Road, #08-62/63
Singapore 329563
Frequently Asked Questions (FAQ)
How Painful Is a Hip Osteotomy?
While some discomfort is expected after any surgical procedure, hip osteotomy pain is manageable. Our hip surgeon prioritises pain management, utilising various medications to ease discomfort during the recovery process. Each patient’s experience with pain will vary, but with proper care, it can be effectively controlled.
How Long Do Hip Osteotomies Last?
The longevity of a hip osteotomy depends on various factors, including the patient’s age, activity level, and the specifics of their condition. Generally, the procedure aims to preserve the natural hip joint, potentially delaying the need for a hip replacement for many years.
Is It Better to Walk or Rest After a Hip Osteotomy?
Post-operative recovery typically involves a balance of rest and gradual mobilisation. Initially, rest can help aid healing, but gentle walking, as recommended by the hip surgeon, can help you regain strength and mobility. We can provide tailored guidance on the appropriate balance between walking and resting during recovery.
What Is the Fastest Way to Recover from a Hip Osteotomy?
Adhering to the prescribed rehabilitation plan and closely following post-surgical instructions provided by the hip surgeon can contribute to a faster recovery. The expertise and guidance of our hip surgeon can help you recover effectively.