Question:My brother had an osteotomy of his hip done. It failed and now he's back to the doctor's to find out what to do. What's usually next after a failed osteotomy?
An osteotomy is used to change the angle of the hip. Sometimes the angle of the thigh bone (femur) as it goes from the knee to the hip socket causes problems. Too much angle causes a small gap between the outer edge of the hip socket and the head of the femur as it sits inside the hip socket.
This uneven angle can cause painful arthritis. Changing the position of the femur in the hip socket can reduce stress on the joint. It can even cause new joint tissue to form. During an osteotomy the doctor takes a pie-shaped piece of bone out of the femur. The gap in the bone is closed and the femur is more vertical with less angle.
Treatment of a failed osteotomy depends on many things. First, what caused it to fail? What's the condition of the bone (weak or strong)? Is there enough bone to do the osteotomy over? Sometimes a simple muscle release is all that's needed.
In more complex cases, the hip must be replaced. The doctor may only have to replace one-half of the joint. X-ray results will show the position and condition of the current osteotomy. The surgeon will decide what to do based on the X-ray results and the patient's report.Kenji Kawate, MD, et al. Twenty-five Years Followup of Patients Who Had Valgus Osteotomy for Arthritic Hips. In Clinical Orthopaedics and Related Research. September 2004. Vol. 426. Pp. 151-158.
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