Open Hip 1

Picture 1: X-ray showing a healed SUFE with malunion and impingement

What is it?

This is a procedure carried out in patients who are not suitable for hip arthroscopy. If a patient has had childhood hip disease such as Perthes, Slipped Upper Femoral Epiphysis or Avascular necrosis, their hip can often be left deformed and this can lead to the femoral head "impinging" against the rim of the acetabular socket. If the deformity is severe, then it is difficult to ensure that a full correction/reshaping has been carried out arthroscopically. In this cases an open procedure is advised.

Investigations Prior to surgery, all patients undergo a detailed physical examination. They will require plain x-rays and 3 D CT scans to give an accurate image of the deformity and allow pre-operative planning.

Procedure Each patient undergoes a general anaesthetic and the procedure takes approximately 2 hours minutes to carry out. All patients are given intra-venous antibiotics and blood thinning drugs to prevent a blood clot.

SUFE
Open Hip 4thumb

Pictures 2 and 3: Photographs of a hip showing a moderate Cam deformity before and after resection.

An incision is made on the side of the hip and a careful dissection is carried out. A portion of bone is removed from the side of the femur, preserving the muscle attachments and the dissection is continued until the hip joint is accessible. The hip is dislocated and a thorough inspection is made of both the femoral head and pelvic socket. Any abnormalities on the socket or cartilaginous labrum are treated at the stage and the head is reshaped using special instruments. Once that is completed, the hip is reduced and the bony fragment is reattached using screws.

Daeefcdab01b02b5402b3e73270f88e7 542x400

Picture 4: Post-operative x-ray following labral repair (note anchors), femoral reshaping and trochanteric reattachment.

Following the surgery, the patient undergoes an active rehabilitation program. This works on restoring range of movement and muscle strength. The patient is usually partially weight-bearing for at least six weeks while the bony repair heals. Patients are usually in hospital for between 2-4 days and are followed up by a dedicated therapist. They are reviewed in out-patients at six weeks and their progress is carefully monitored.

The speed of patient recovery can vary following the operation and most return to normal activities 6 to 12 weeks following surgery.

Open hip debridement is a significant procedure and the risks are greater than with hip arthroscopy. There is a small risk of infection, blood clots, temporary nerve injury and non-union of the bony fragment. Some patients will get discomfort from the screws and these may need to be removed as a day-case procedure.

Manchester Hip Clinic News

HIP SURGERY

Fracture

As patients who have had a hip replacement age, there is a decrease in the strength of their bones and an increase in the risk of fracture a...

HIP SURGERY

Dislocation

As hip replacements age, the components will wear and the hip will lose its' initial soft-tissue tension. This combined with a general incre...

HIP SURGERY

Hip Arthroscopy

This is an innovative procedure that allows access to the hip joint using minimally invasive surgical techniques. It has been carried out ep...

HIP SURGERY

Hip Replacements

When a patient has severe arthritis and painkillers no longer effectively control the symptoms, hip joint replacement is advised. This has t...

HIP SURGERY

Implant loosening

Implant loosening is the most common cause/indication for revision hip surgery. Hip replacements have been carried out in the UK regularly s...

HIP SURGERY

Hip revision surgery

Revision hip surgery is carried out for a variety of reasons. These can include the original hip wearing out, the presence of deep infection...

Contact Details

Fracture Image 1a

Spire Manchester Hospital,
Russell Road, Whalley Range,
Manchester. M16 8AJ
Tel: 0773 979 1305
info@manchesterhipclinic.com