This condition involves the improper development of the hip joint, leading to instability, pain, and increased risk of osteoarthritis.
Hip Osteotomy Specialist In Singapore
Dr Wang Lushun
Senior Consultant Orthopaedic Surgeon
MBBS (Singapore)
MRCS (Edin)
MMed (Ortho)
FRCS (Ortho) (Edin)
- Fellowship-trained orthopedic surgeon
- Internationally recognised, more than 1500 surgeries performed
What is Hip Osteotomy?
Hip osteotomy is a surgical procedure designed to correct misalignments or deformities within the hip joint and redistribute joint pressures evenly. This operation is generally considered for patients whose conditions have not improved with conservative treatments, such as physical therapy or medication.
It targets abnormalities like developmental dysplasia or femoroacetabular impingement (FAI), which can disrupt the hip’s natural movement and alignment. By realigning the hip joint components, the surgery seeks to preserve the joint’s integrity and delay the onset of arthritis.
Types of Hip Osteotomy
The hip joint's complex anatomy and the variety of conditions affecting its function necessitate a tailored approach to surgery. Different types include:
Periacetabular Osteotomy (PAO)
This procedure is designed to correct dysplasia of the acetabulum, the socket part of the hip joint and aims to improve joint stability and function while reducing the risk of osteoarthritis development.
Femoral Osteotomy
Femoral osteotomy focuses on both the thigh bone (femur) and hip bone. The procedure adjusts the length, angle, or rotation of the femur to improve its fit within the acetabulum.
Intertrochanteric Osteotomy
It is used to correct abnormal hip mechanics and is often employed in the treatment of hip arthritis, particularly in younger patients. This type involves cutting and realigning the bone between the greater and lesser trochanters of the femur.
Indications for Hip Osteotomy
Hip osteotomy is recommended for various conditions where the hip joint’s alignment, shape, or function is compromised. Key indications include:
Developmental Dysplasia
Femoroacetabular Impingement (FAI)
FAI is a condition where extra bone grows along one or both of the bones that form the hip joint, which may rub together and cause pain.
Legg-Calve-Perthes Disease
This condition results from inadequate blood supply to the femoral head, leading to bone death.
Nonunion or Malunion of Fractures
In cases where hip fractures have not healed correctly (nonunion) or have healed in an improper position (malunion), an osteotomy can correct the alignment to relieve pain.
Osteoarthritis
In younger patients with early-stage osteoarthritis, osteotomy can help realign the hip joint to distribute weight more evenly across the cartilage, potentially delaying the need for a hip replacement.
Preoperative Care and Evaluation
The efficacy of a hip osteotomy relies on detailed preoperative evaluation and preparation, involving a review of medical history, physical exams, and imaging studies to assess the hip’s structural and alignment issues. Gait analysis may also be employed to understand the impact of hip conditions on walking patterns, including procedure type and necessary adjustments.
<blockquote>Patient education on expected outcomes, potential risks, and rehabilitation, alongside ensuring mental and physical readiness for surgery by managing pre-existing conditions, may help minimise risks and promote effective healing.</blockquote>
Surgical Procedure Overview
The hip osteotomy procedure is performed under general anaesthesia and involves several key steps:
Incision and Exposure
The surgeon makes an incision over the hip to expose the bones that will be cut or realigned. The approach and size of the incision depend on the specific osteotomy type.
Bone Cutting and Realignment
Using specialised tools, the surgeon cuts the bone (or bones) according to the preoperative plan. The bone is then realigned to improve the hip joint’s alignment and function. This may involve changing the hip bones’ angle or rotation or shifting the hip socket’s position.
Fixation
Once the bones are correctly aligned, they are secured in place using surgical hardware such as screws, plates, or pins. This fixation ensures that the bones remain in the correct position while they heal.
Closure
The incision is closed with sutures or staples, and a dressing is applied to the wound. In some cases, a drain is inserted to remove excess fluid from the surgical site.
Immediate Postoperative Care
After surgery, the patient is moved to a recovery area where they are closely monitored. Pain management and preventing complications, such as blood clots, are primary concerns during this period.
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Postoperative Care and Recovery Process
The postoperative phase ensures a successful outcome after hip osteotomy. Key components include:
Pain Management
Using analgesics and anti-inflammatory drugs for comfort and minimal side effects.
Physical Therapy
Initiating early mobility and tailored exercises to enhance joint strength and flexibility.
Wound Care
Ensuring surgical site hygiene to avert infection, with clear guidelines for wound maintenance.
Follow-up Appointments
Conduct regular checks to assess healing and implant integrity, often incorporating imaging tests.
Activity Modification
Advising on activity adjustments to safeguard the hip during recovery, including a phased return to daily routines.
Risks and Complications
As with any surgical procedure, hip osteotomy carries certain risks and complications, including:
Infection
Infection at the surgical site or hardware can occur, requiring antibiotics or additional surgery.
Blood Clots
The risk of developing blood clots in the legs or lungs is increased, necessitating preventive measures such as blood thinners and early mobilisation.
Nerve Injury
There is potential nerve damage during surgery, leading to numbness, tingling, or weakness.
Nonunion or Malunion
The bones may not heal properly or may heal in an incorrect position, sometimes necessitating further surgery.
Hardware Issues
Complications related to the surgical hardware, such as loosening or breakage, may require removal or replacement.
Outcomes and Prognosis of Hip Osteotomy
Hip osteotomy offers good to excellent outcomes for many patients, particularly those who are carefully selected and comply with postoperative care guidelines. However, the long-term success of the surgery depends on various factors, including the underlying reason for the osteotomy, the patient’s age, activity level, and adherence to rehabilitation.
While hip osteotomy can provide lasting benefits, some patients may eventually require hip replacement surgery as they age or if arthritis progresses.
Dr Wang Lushun
Senior Consultant Orthopaedic Surgeon
MBBS (Singapore)
MRCS (Edin)
MMed (Ortho)
FRCS (Ortho) (Edin)
Internationally Recognised & Double Fellowship-Trained Surgeon With Over 18 Years of Experience
- Bachelor of Medicine & Bachelor of Surgery (MBBS),
National University of Singapore - Member of The Royal College of Surgeons (MRCS),
Edinburgh, United Kingdom - Master of Medicine in Orthopaedic Surgery (MMed),
National University of Singapore - Fellow of The Royal College of Surgeons in Orthopaedics and Traumatology (FRCS), Edinburgh, United Kingdom
As a Senior Consultant Orthopaedic Surgeon and former Head of the Hip and Knee Division in Ng Teng Fong Hospital, he has won awards for superior patient outcomes (value driven), service quality and enhanced recovery programmes. His patients include current and former national athletes and sporting professionals.
Why Choose
Dr Wang Lushun?
Trusted
Leadership on Orthopaedic Advisory Boards
Skilful
Double Fellowships at Centres of Excellence
Experienced
Senior Consultant with Over 18 Years of Experience
Can I Use Medisave For My Treatment?
Yes, you can use funds from your Medisave account to offset the cost of your treatment.
Reach out to us today to learn more about payment options.
Patient-Centred Orthopaedic Care
We are dedicated to your recovery and well-being. Every patient deserves the freedom that comes with active living. Whether you're an athlete sidelined by an injury or a weekend hobbyist desperate to return to your passion, our mission is to help you regain your mobility and independence.
Personalised Approach For Positive Outcomes
Our clinic prioritizes time dedicated to understanding each patient’s injuries and needs. Dr Wang strongly believes that personalised care & patient management will lead to better outcomes & positive experiences.
Minimally Invasive Techniques For Faster Recovery
Dr Wang’s extensive experience with minimally invasive procedures allows for less scarring, lower risk of complications and faster recovery compared to traditional surgical methods.
Aftercare Focused On Restoring Mobility & Well-Being
As an avid sportsperson, Dr Wang understands the time and patience required to regain mobility and return to active living. After your procedure is completed, Dr Wang will make sure your recovery is smooth and comfortable.
Insurance
We accept all patients, with or without insurance plans. Additionally, we are on the specialist panels of these Health Networks/Insurance Plans. Please contact us if you have any queries and we will be happy to assist you in checking with your insurance provider.
Our Clinic Locations
3 Mount Elizabeth, #13-14
Mount Elizabeth Medical Centre
Singapore 228510
820 Thomson Road, Mount Alvernia Hospital, #05-51, Medical Centre D, Singapore 574623
Frequently Asked Questions (FAQs)
Who needs a hip osteotomy?
Hip osteotomy is typically recommended for people with hip dysplasia, a condition where the socket of the hip joint is not properly formed or positioned. It can also be used to treat other hip conditions, such as femoroacetabular impingement or hip instability.
Can hip osteotomy delay the need for hip replacement surgery in all patients?
While hip osteotomy aims to realign the hip joint and potentially delay the progression of degenerative changes, whether it can postpone the need for hip replacement surgery depends on factors such as age, activity level, and the severity of the condition.
How do surgeons decide between performing a periacetabular osteotomy (PAO) and a femoral osteotomy?
The decision between a PAO and femoral osteotomy is based on a comprehensive evaluation of the hip joint’s structure, the patient’s specific anatomical abnormalities, and the surgery goals to achieve optimal joint alignment and function.