Acetabular Hip Osteotomy
An acetabular osteotomy is a potential treatment option for some patients with developmental dysplasia of the hip that results from malformation of the acetabulum (hip socket). Treatment of hip dysplasia with acetabular osteotomy in young and active patients can help prevent the development of early hip osteoarthritis.
An osteotomy involves making a cut in a bone in order to move the bone into a better position. An acetabular osteotomy refers to cutting and repositioning the bones around the hip joint so that surgical remodeling of the bones can occur in order to distribute force more evenly over the joint’s articulating surfaces. This type of surgery aims to reduce the risk of hip dislocation and subluxation. It also has the goal of preventing uneven wearing of the hip over time, which can delay the onset and progression of osteoarthritis that often result from hip dysplasia.
In an acetabular osteotomy, cuts are made around the acetabulum of the hip joint so the acetabulum can be repositioned in the pelvis. The location of the cuts can vary depending on the surgical approach used. After freeing the acetabulum, the resultant bone fragments are aligned correctly and fixed in place with screws, with the goal of correcting any abnormalities in the shape and location of the acetabulum. One aim of this procedure is to increase coverage of the femoral head (ball) by the acetabulum. The amount of acetabular correction made during the osteotomy procedure is highly individualized considering that the extent of hip dysplasia varies for each individual.
Recovery from an acetabular osteotomy includes limiting weight-bearing through the hip until adequate bone healing has occurred. This can take 6-8 weeks to accomplish. Once adequate bone healing is achieved, the patient can gradually increase the amount of weight placed on the hip until full weight-bearing can occur.
In the post-operative period, a blood thinner such as aspirin may be recommended in order to minimize the risk of blood clot (deep vein thrombosis) formation. Physical therapy and in-home exercises are also an important component of recovery. Special exercises aimed at recovery allow the individual to regain full range of motion and strength in the hip. Recovery from an acetabular osteotomy will take several months and often more than a year as union of the bone in its new position takes time.
Potential complications of acetabular osteotomy include:
- Injury to the lateral femoral cutaneous nerve of the thigh and/or sciatic nerve
- Deep vein thrombosis or pulmonary embolism
- Surgical site infection
- Intra-articular hip fracture