Hip Osteotomy Surgery Cost and Procedure Information

Goals of hip osteotomy surgery

Hip osteotomy surgery can reduce pain and mobility limitations caused by several conditions linked to poorly aligned hip joints. The overall aim of hip osteotomy is to remove pressure from damaged areas of the joint by realigning the ball or socket of the hip joint.

Easing stress on the joint can treat or delay the progression of a range of conditions, including:

• Osteoarthritis
• Hip dysplasia

Hip osteotomy can also help prevent a patient from ever developing osteoarthritis or requiring a hip replacement. This is done by relieving stress from how the joint moves and preventing the damage that would otherwise lead to osteoarthritis.

Candidates for hip osteotomy

In general, an ideal candidate for hip osteotomy is:

• Under 60 years of age
• Generally healthy
• Active in their daily life
• Has no hip inflammation or deformation
• Has healthy hip joint cartilage

Before the procedure, patients should aim to be as fit and healthy as possible. Easy ways to do this include:

• Maintaining an optimal and sustainable weight for your body
• Keep active or begin a physician-recommended exercise program before surgery
• Stop smoking or using any nicotine product at least 6 weeks before surgery
• Reduce alcohol intake

Committing to healthy practices before surgery not only has a significant positive impact on recovery in the short term. It also positively impacts the health of the hip after recovery. As a result, hip joint replacement may be a better treatment option for patients with severe hip dysplasia or osteoarthritis.

Cost of hip osteotomy surgery

Prices for orthopaedic surgery in the UK vary widely, and this is no different for hip osteotomy. Across the UK, private hip osteotomy costs from £2,000 up to £6,000 or more. The wide range in price is dependent on several factors, including where the hospital is located, the surgeon operating, and what pre-or post-operative services are included in the price.

The hip osteotomy surgery procedure

In general, hip osteotomy takes between 1.5 to 2 hours. The surgeon will walk through their entire treatment plan well before surgery, so patients are fully informed before having the procedure.

Anaesthetic

A hip osteotomy may be performed under a general anaesthetic or a spinal anaesthetic with sedation. The surgeon will decide on the type of anaesthetic to use based on the complexities of the procedure and the patient's general health. For general anaesthesia, patients will be given a medication that puts them into a deep, dreamless sleep for the duration of the operation. Spinal anaesthesia is also called an epidural or spinal block. For this, numbing medication is carefully injected into the spine to block any feeling in the body below the injection temporarily. A sedative is also administered so you feel relaxed during the surgery.

The hip osteotomy procedure

Either the ball or socket of the hip joint can be adjusted during hip osteotomy surgery. Each patient’s hip will be aligned in a way that best suits their body, but the general surgical procedure is similar for every patient.

Femoral osteotomy

This type of hip osteotomy surgery focuses on correcting the hip joint ball at the top of the thigh bone called the femur.

1. The top of the femur is cut to release the ball of the hip joint
2. The ball is repositioned with temporary screws
3. X-rays are used to help the surgeon decide if the new placement is correct
4. When they are happy with the alignment, they secure it into the new position with a metal plate and screws

The image below is an x-ray of a patient’s hip 1 year after femoral osteotomy and shows the permanent screws and metal plate used to position the bone.

Periacetabular osteotomy

This technique is most commonly used to treat hip dysplasia where the socket of the hip joint is too shallow to fit the ball of the joint.

1. The bones of the pelvis are cut to release the acetabulum
2. The socket is repositioned with temporary screws
3. X-rays are used to check the alignment of the acetabulum with the femur
4. When they are happy with the position, they secure the acetabulum into its new position with screws and metal plates

Sometimes bone grafts are used to fill in large gaps between the acetabulum and pelvic bones and encourage the bone to heal into place.

Patients will be encouraged to try and stand on the first day after surgery, and they will likely attempt this with the support and oversight of a physiotherapist. Providing all else is well, patients will be able to go home when they can move around independently. Most patients stay anywhere between 2 to 4 nights in the hospital before going home. Patients will be advised not to put their full weight on their hip for several weeks after surgery. Patients will be given a mobility aid such as crutches to help them move around as they recover. As recovery progresses, they will be able to use the aid less and less.

Hip osteotomy aftercare

A physiotherapy programme will be personally designed for the patient by the surgeon and physiotherapist. Patients may have physiotherapy or hydrotherapy appointments for several months after surgery.

It is crucial to follow the exercise and stretching plans given by the physiotherapist and surgeon exactly. These exercises and stretches are intended to help restore strength, stamina and range of motion to the hip and help ensure the hip recovers well. Exercises and stretches also help ensure the future health of the hip as well.

Potential hip osteotomy surgery risks & complications

Hip osteotomy is associated with potential risks and complications like any other surgical procedure. Patients must be aware of these risks and understand them before agreeing to have surgery. If patients have any questions about any of the topics listed here, the surgeon will be happy to discuss them in more detail.

Risks and complications associated with hip osteotomy surgery include:

• Bruising & bleeding
• Infection
• Blood clots
• Screw displacement
• Nerve damage
• Failure of the bone to heal
• General surgical complications

On average, hip osteotomy surgery takes between 1.5 to 2 hours to complete.

Alternative treatments for people with hip dysplasia include hip resurfacing (where metal ‘caps’ are used to recover the hip bones) and a total hip replacement (where the whole joint is replaced). Your surgeon will be able to discuss the potential alternatives with you at your consultation so you can make a decision that is best for you.

The recovery process varies from person to person. Generally, the timeline for exercise can be longer for an osteotomy when compared to other procedures such as hip resurfacing or hip arthroscopy.

Lower-impact activities like riding a static bike may be resumed after 10 or 12 weeks.

For high-impact exercises (such as jogging), you will need to build up to these very gradually to ease your hip joint into the new movement and prevent any injury or damage. You should be able to fully resume high-impact activities at around 5 months. However, be aware this may take longer depending on how you heal.

While returning to your usual exercise routine is a focus, your surgeon or physiotherapist may advise you to avoid certain activities altogether depending on the condition of your hip. It may take at least 6 months for you to return to some impact sports. The advice for returning to sexual activity varies, so make sure you ask your surgeon about this.

Anyone having a hip osteotomy will be given a tailor-made physiotherapy program. It is most important you follow this guidance. These exercises and instructions help ensure the lasting effect of your procedure and the future health of your hip.

Your physiotherapy will begin when you are in hospital then you will be given follow up appointments to attend as well as work to do when you are home. As your recovery progresses, you will require fewer physiotherapy and aftercare appointments. Many patients begin tapering off physiotherapy after about 2 or 3 months.

All of the information found on our website is sourced from highly reputable experts, government-approved authorities and is widely used by healthcare professionals.

• https://www.roh.nhs.uk/ NHS
• https://hipdysplasia.org/ International Hip Dysplasia Institute
• Uptodate.com Up to Date

Our content is written by our Medical Quality Managers and Patient Care Advisers, all of who have medical backgrounds and training. In addition, before publishing, all the information is reviewed by a surgeon specialised within the relevant field.