Osteotomies around the hip

Osteotomies around the hip

The goal of an osteotomy around the hip is to redistribute forces evenly across the joint, thereby eliminating excessive point loading. This can be achieved by performing an oste - otomy on the femoral or the acetabular side, depending upon the desired goal, e.g. an excessive valgus neck–shaft angle and an uncovered femoral head on the lateral aspect can be corrected by carrying out a v arus femoral osteotomy . Similarly , a redirection osteotomy on the acetabular side can also be performed to improve coverage of the femoral head in cases of hip dysplasia. The common indications for an osteotomy around the hip in the adult age group are shown in Table 39.4 . Ideally , an osteotomy should be considered in a young patient who maintains a good range of movement of the hip and whose imaging studies (radiographs and/or CT scan or MRI scan) show a joint devoid of significant degenerative change. - Thorough preoperative planning is essential to assess whether the desired position can be achieved. Increasingly 3D CT scans are used for preoperative planning. In addition, 3D printing has been used to understand the problem and plan surgical correction. Computer navigation and robotics are novel adjuncts that are aimed at obtaining an accurate correc - - tion of the concerned deformity .

TABLE 39.4 Indications for osteotomy around the hip in the adult age group. Femoral osteotomy Periacetabular osteotomy (PAO) Developmental dysplasia of Perthes’ disease the hip Osteoarthritis in a young patient Acetabular retroversion (reverse Slipped capital femoral PAO) epiphysis Avascular necrosis

Osteotomies around the hip

The goal of an osteotomy around the hip is to redistribute forces evenly across the joint, thereby eliminating excessive point loading. This can be achieved by performing an oste - otomy on the femoral or the acetabular side, depending upon the desired goal, e.g. an excessive valgus neck–shaft angle and an uncovered femoral head on the lateral aspect can be corrected by carrying out a v arus femoral osteotomy . Similarly , a redirection osteotomy on the acetabular side can also be performed to improve coverage of the femoral head in cases of hip dysplasia. The common indications for an osteotomy around the hip in the adult age group are shown in Table 39.4 . Ideally , an osteotomy should be considered in a young patient who maintains a good range of movement of the hip and whose imaging studies (radiographs and/or CT scan or MRI scan) show a joint devoid of significant degenerative change. - Thorough preoperative planning is essential to assess whether the desired position can be achieved. Increasingly 3D CT scans are used for preoperative planning. In addition, 3D printing has been used to understand the problem and plan surgical correction. Computer navigation and robotics are novel adjuncts that are aimed at obtaining an accurate correc - - tion of the concerned deformity .

TABLE 39.4 Indications for osteotomy around the hip in the adult age group. Femoral osteotomy Periacetabular osteotomy (PAO) Developmental dysplasia of Perthes’ disease the hip Osteoarthritis in a young patient Acetabular retroversion (reverse Slipped capital femoral PAO) epiphysis Avascular necrosis

Osteotomies around the hip

The goal of an osteotomy around the hip is to redistribute forces evenly across the joint, thereby eliminating excessive point loading. This can be achieved by performing an oste - otomy on the femoral or the acetabular side, depending upon the desired goal, e.g. an excessive valgus neck–shaft angle and an uncovered femoral head on the lateral aspect can be corrected by carrying out a v arus femoral osteotomy . Similarly , a redirection osteotomy on the acetabular side can also be performed to improve coverage of the femoral head in cases of hip dysplasia. The common indications for an osteotomy around the hip in the adult age group are shown in Table 39.4 . Ideally , an osteotomy should be considered in a young patient who maintains a good range of movement of the hip and whose imaging studies (radiographs and/or CT scan or MRI scan) show a joint devoid of significant degenerative change. - Thorough preoperative planning is essential to assess whether the desired position can be achieved. Increasingly 3D CT scans are used for preoperative planning. In addition, 3D printing has been used to understand the problem and plan surgical correction. Computer navigation and robotics are novel adjuncts that are aimed at obtaining an accurate correc - - tion of the concerned deformity .

TABLE 39.4 Indications for osteotomy around the hip in the adult age group. Femoral osteotomy Periacetabular osteotomy (PAO) Developmental dysplasia of Perthes’ disease the hip Osteoarthritis in a young patient Acetabular retroversion (reverse Slipped capital femoral PAO) epiphysis Avascular necrosis