Name of the Procedure:

Osteotomy, iliac, acetabular or innominate bone; with femoral osteotomy

Summary

An osteotomy involving either the iliac, acetabular or innominate bones, combined with a femoral osteotomy, involves surgically cutting and realigning the bones of the hip and thigh. This complex orthopedic procedure aims to correct bone deformities, improve joint function, or alleviate pain.

Purpose

This procedure addresses conditions like hip dysplasia, severe osteoarthritis, congenital hip dislocation, or other hip deformities. The goals are to realign the hip for better function, alleviate pain, delay or eliminate the need for joint replacement, and enhance mobility and quality of life.

Indications

• Painful hip joint due to structural deformities
• Limited hip motion or function
• Congenital or developmental conditions causing joint misalignment
• Severe cartilage damage or degeneration
• Patients usually are younger and active, who require bone realignment to preserve the joint

Preparation

• Patients may need to fast for several hours before the procedure
• Blood tests, X-rays, and MRI or CT scans
• Stopping or adjusting certain medications as advised by the doctor
• Preoperative consultation to discuss anesthesia options and post-surgery care

Procedure Description

1. The patient is positioned on the operating table, and general anesthesia is administered.
2. A surgical incision is made to access the hip and thigh bones.
3. The surgeon cuts the iliac, acetabular or innominate bone, and the femur to realign them appropriately.
4. The repositioned bones are fixed in place using metal plates, screws, or rods.
5. The incision is closed with sutures or staples and dressed.

Duration

The procedure typically takes around 2 to 4 hours, depending on the complexity and the specific bones involved.

Setting

This surgery is performed in a hospital operating room equipped with specialized tools for orthopedic surgery.

Personnel

• Orthopedic surgeon
• Anesthesiologist
• Surgical nurses
• Surgical technologists
• Physical therapists (post-surgery)

Risks and Complications

• Infection at the surgical site
• Blood clots
• Nerve or blood vessel damage
• Nonunion or malunion of the bones
• Hardware complications (e.g., irritation, loosening)
• Postoperative pain and swelling
• Limited hip movement temporarily during recovery

Benefits

• Improved hip alignment and function
• Pain relief
• Enhanced mobility and ability to perform daily activities
• Potential delay or prevention of total hip replacement Benefits are typically realized within several months postoperatively, with continued improvement as rehabilitation progresses.

Recovery

• Hospital stay for a few days post-surgery
• Limited weight-bearing on the affected leg for several weeks
• Physical therapy to restore strength and mobility
• Pain management with prescribed medications
• Follow-up appointments for X-rays and progress evaluation
• Full recovery and return to activities may take 6 months to a year

Alternatives

• Conservative treatments like physical therapy, medications, and activity modification
• Hip resurfacing surgery
• Total hip replacement These alternatives have their own risks and benefits; for example, conservative treatments may not provide lasting relief for severe deformities, while total hip replacement is more invasive but may offer quicker pain relief.

Patient Experience

Patients might feel groggy from anesthesia initially and experience pain and swelling at the surgical site, managed with medication. Physical therapy may involve some discomfort. Gradual improvement in motion and reduction in pain can be expected as recovery progresses.