Hip Reconstructive Surgery

Hip Reconstructive Surgery at a Glance

Reconstruction means performing a surgery to fix problems with structure or function of a body part, or to correct an abnormality or defect. Hip reconstructive surgery is a surgical procedure done to restore your mobility and alleviate hip pain.

Hip, the largest joint in the body, is a ball and socket joint composed of head of the femur (thigh bone) and the acetabulum, which is a concave indentation in the pelvic bone. Ligaments and cartilage surrounding the hip joint provide mobility and stability. Over the course of life or due to any trauma and other medical conditions, the hip cartilage may experience some wear and tear, which may develop to a condition called arthritis, which often causes pain. Arthritis gradually worsens with time, and requires proper treatment.

If arthritic pain and range of motion of the joint are not relieved by non-surgical treatment options, surgical treatments are opted which also includes hip reconstructive surgery.

The main aim of hip reconstructive surgery is to restore range of motion of the hip joint and to relieve pain, offering the patient increased mobility, independence and an improved quality of life.

Hip reconstruction involves different surgical procedures. A few of these procedures are:

  • Hip replacement or hip arthroplasty
  • Hip resurfacing
  • Hip osteotomy
  • Hip arthroscopy

Hip Replacement or Hip Arthroplasty

A hip replacement procedure is a major surgery that involves the removal of the damaged joint surface and replacing it with artificial implants or prostheses.

Hip Resurfacing

Hip resurfacing procedure also involves artificial joint parts but unlike traditional hip replacement surgery, it does not involve removal of femoral head. Instead, it is trimmed and capped with a smooth metal covering. The damaged bone and cartilage within the socket are removed and replaced with a metal shell.

Hip resurfacing has many advantages over total hip replacement surgery.

  • With hip resurfacing, much more natural bone can be preserved than a standard hip replacement.
  • Hip resurfacing is suitable for younger patients, less than 60 years of age.
  • Hip resurfacing allows greater range of motion than total hip replacement.
  • There is a lesser risk of hip dislocation after hip resurfacing than after total hip replacement.
  • Unlike hip replacement surgery, hip resurfacing is easier to revise. Although rare, hip resurfacing may have some complications like femoral neck fracture, injuries to nerves and blood vessels, infection, dislocation and formation of blood clots in the leg veins.

Generally, patients are discharged after three or four days of hip resurfacing surgery. Physical therapy is recommended to help maintain your range of motion and restore your strength.

Hip Osteotomy

Hip osteotomy is a surgical procedure in which hip bones are cut, reshaped and fixed in a new position to realign the load bearing surfaces of the joint. It is indicated for the treatment of hip fracture non-unions and mal-unions and in cases of congenital and acquired hip deformities.

Hip osteotomy is used to treat younger patients who are not considered for hip replacement surgery due to their active lifestyles. Generally, a hip replacement may last for about 20 years and in younger patients, this time is not acceptable. With osteotomy, a hip replacement surgery can be delayed as long as possible.

There are mainly two types of hip osteotomy procedures, based on the type of bone correction required:

  • Femoral osteotomy—if femur bone is deformed.
  • Pelvic osteotomy—if acetabulum is deformed and requires correction.

Usually the patient requires several days’ hospitalization after hip osteotomy. A cast known as spica cast is applied and the patient is kept restricted to bear full weight of the upper body for about 8 to 10 weeks.

Though rare, some patients may develop some complications like an infection, blood clot formation or an injury to nerves or blood vessels.

Most patients have good outcomes after hip osteotomy. Full recovery from the procedure may range from 6 to 12 months.

Hip Arthroscopy

Hip arthroscopy is a minimally-invasive surgical procedure done with the help of an arthroscope, a long tubular device with a camera that projects images on a screen. Hip arthroscopy is recommended to treat the following conditions:

  • Dysplasia
  • Loose bodies
  • Hip joint infection
  • Synovitis
  • Snapping hip syndrome

Hip arthroscopy is an outpatient procedure. Usually, the patient is discharged one or two hours after surgery. Full recovery may take one to two months depending on the extent of the problem. Physical therapy is helpful to restore range of motion and speedy recovery.

Contact your orthopedic surgeon to determine for sure whether you are a candidate for hip reconstructive surgery. Hip reconstructive surgeries are highly successful. Most patients report significant relief in pre-surgical pain and an increase in range of motion after hip reconstructive surgery.

Sources

American Academy of Orthopaedic Surgeons
Reconstructive Surgery Guide