A joint is formed by the articulation of two or more bones. The articulating surfaces of the bones in a joint are covered with smooth, shiny, white connective tissue called cartilage that reduces friction. The joints are surrounded by ligaments which are strong rope like structures that hold the different bones of the joint together, allowing controlled movement of the joint and preventing dislocation.
The joint may be damaged secondary to wear with repeated use, disease or an injury. This causes pain, stiffness and swelling. Initially non-surgical treatments are recommended to relieve pain, reduce swelling and promote healing. However, surgery may be recommended in patients who fail to benefit from non-surgical modalities of treatment. Surgery may involve joint reconstruction or joint replacement. Orthopedic disorders that may require surgical treatment include degenerative joint disease, cartilage and labral injury, joint malalignment and ligament or tendon tear.
Surgical treatment significantly reduces joint pain and improves the patient’s quality of life helping them resume an active lifestyle. The surgical procedures may include cartilage restoration, ligament and tendon repair, osteotomy, joint resurfacing and / or total joint replacement depending on the condition of the joint of individual patient.
Complex Hip Surgery
The hip joint is one of the body’s largest weight-bearing joints and is the point where the thigh bone (femur) and the pelvis (acetabulum) join. It is a ball and socket joint in which the head of the femur is the ball and the pelvic acetabulum forms the socket. The joint surface is covered by a smooth articular cartilage that cushions and enables smooth movements of the joint. Congenital deformities, complex fractures and complex injuries affect more than one structural component of the hip joint. Thus their treatment requires an individualized approach which includes proper diagnosis and a unique treatment plan, depending on the individual problem, which may involve more than one type of treatment and surgery. These reconstructive surgeries are categorized as complex hip surgeries. They aim at reconstructing the hip joint rectifying the patient specific problem to relieve pain and provide best possible stability and function. They also include surgeries to reconstruct bones of the hip after removal of a part of the bone to treat bone cancer.
Complex hip reconstruction surgeries may include:
Open and Closed Reduction: These are used mainly to treat complex fractures. In open reduction, the surgeon makes an incision on the skin and inserts internal fixators such as wires, screws, pins, or plates either in front or back of the pelvis. In closed reduction the surgeon places external fixators such as pins or screws into the fractured bone on either side of pelvis without making any incision. These pins are then connected to clamps or rods outside the skin which forms an external frame that brings about stability and allows the bone to heal.
Acetabular and Femoral Osteotomy: Periacetabular osteotomy is a surgical procedure to treat hip dysplasia. Patient suffering from this condition have a shallow socket (acetabulum) of the hip joint. In this procedure the acetabulum is separated from the pelvic bone and is then repositioned using screws to allow for a better fit of the femoral head in the same acetabulum. Sometimes cutting and repositioning of the femoral head is also required and is done by a separate surgery called femoral osteotomy.
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