For which conditions Hip osteotomy is done for an How?

For different conditions hip osteotomy is done. The most common conditions are:

• Correction of deformity, like

i. Coxa Vara of the hip where the angle between the ball and the femur shaft becomes less and the neck gets lots of stress. By doing osteotomy just below the change of angle the neck shaft angle can be increased. The osteotomy is fixed with a specialised anatomical plate to get the desired change in angle.

ii. Coxa Valga of the hip where the angle between the ball and the femur shaft becomes more and the hip joint loses its rotational movement capacity. By doing osteotomy just below the change of angle the neck shaft angle can be increased. The osteotomy is fixed with a specialised anatomical plate to get the desired change in angle.

iii. In developmental dysplasia of the hip where the head remains relatively back of the femur long axis with an increased neck shaft angle which prevents the femur head to remain inside the acetabular cup. By doing a derotation varus osteotomy the tendency of the femur head to remain dislocated can be negotiated. Where an osteotomy is done just below the change of angle and is fixed with a specialised plate after providing the required rotational change to achieve both the rotation and neck shaft angle correction.

• Enhance union potential in non-union of fracture neck of femur (NOF). Sometimes the fracture line in NOF creates so vertically that the gravitational force transferring through hip joint and femur produces a shearing force at fracture site which causes failure of fixation before the union happens. In this situation an osteotomy is done just below the change of angle and is fixed with a special plate called double angle ‘Angle Blade Plate.’ Thus the shearing force passing through the fracture became compression force as it changed from vertical position to a horizontal position.

• Enhance healing and prevent collapse of femur head cartilage by shifting the diseased area from weight bearing contact and bringing the healthy area here.