Surgical Realignment of the Hip (Osteotomy)

Surgical realignment of the hip is a surgery to correct problems in the femur or hip joint. This procedure may be performed as an alternative to total hip replacement. 

A hip realignment may be necessary when you experience a hip dislocation or when the pain from hip impingement becomes unbearable. 
Posterior dislocation is the most common type of hip dislocation that occurs when the thigh bone is pushed out of the socket backward.During the realignment surgery, your orthopedic surgeon will cut the pelvic bone(s), move it back to its normal place, and remove any other bone fragments in the hip. Your hip will not heal properly and will stay out of alignment if bone fragments remain in the area. 

Candidates for surgical hip realignment

If you are not a candidate for a hip replacement, your doctor may recommend a surgical realignment of the hip. 

Fractures or dislocations and associated damage that may require a medical hip realignment include:

• Industrial accidents
• Automobile accidents
• Falling from a high place, such as from a ladder.

When performed early, realignment surgery can reduce pain and delay the onset of arthritis in the hip.

Risks associated with surgical realignment of the hip

Complications related to surgical hip realignment include:

• Blood clots. You will be given a blood thinner, compression stockings, and compression boots to avoid the risk of blood clots. 
• Infection. You will be given IV antibiotics before and after surgery to prevent infection.
• Inability to heal. You may need additional surgery if the bone does not heal correctly.
• Nerve palsy. In rare cases, nerves can be damaged.

Preparing for surgical realignment of the hip

In preparation for surgery, your doctor will take X-rays and MRIs to evaluate the severity of your case. 

Before you undergo a hip surgical realignment, your doctor will advise you to do the following:

• If you are overweight, lose extra weight. 
• Stop smoking.
• Stretch and strengthen your muscles in your abdomen and legs.
• Arrange to have a driver for three or four weeks after surgery.
• Do not take any blood thinners before surgery.
• Prepare your home for after surgery when you are not able to move around as well.

What to expect during a surgical realignment of the hip

Your doctor will perform surgical realignment of the hip under general anesthesia. During the surgery, your orthopedic surgeon will:

• Make an incision approximately six to eight inches long at the hip joint. 
• Using X-ray guidance, your surgeon will cut out the damaged bone and tissue to free it from its original position.
• Prepare the bone graft that will be used in the hip joint. 
• Place the bone graft in place and stabilize the joint with metal screws, plates, and pins. 

Once the area is located, your doctor will cut out the damaged bone and tissue. 

Recovery after surgical hip realignment 

Recovery from a hip medical realignment procedure is lengthy.

For approximately six weeks after surgery, you will take a blood thinner, wear a compression hose, and walk with crutches. Your doctor will give you pain medication, if necessary. You can typically begin driving again three to four weeks after surgery after you get off narcotics.

Six weeks after surgery, you will transition to using one crutch and may start stretching or strengthening exercises.

After three months, you may return to work as tolerated. Your doctor will encourage you to do gentle exercises or walk.

Six months after surgery, as bone cuts heal, you can return to your normal activity level, except for running and jumping activities.