Hip Distraction

DESCRIPTION

The hip joint consists of a ball (femoral head) and socket (acetabulum) that are surrounded by large strong muscles and tough ligaments which enable the body to walk, run, bend, and perform other movements. Given the hip’s important role in motion and the amount of force generated, the hip is subject to a great deal of wear and tear that can cause a variety of issues. Hip distraction is a procedure that is used to correct and repair components of the hip while keeping the surrounding muscles in place.

CONDITIONS TREATED

  • Avascular necrosis of the hip
  • Arthritis in younger people
  • Femoracetabular impingements (a condition where the hip bones have an abnormal shape)
  • Chondrolysis (gradual degradation of hyaline cartilage in the hip joint)

PROCEDURE

Under general and/or spinal anesthesia, an incision is made on the side of the leg near the hip and upper thigh area. The greater trochanter (a thick piece of bone measuring approximately 1.5cm) is cut from the upper part of the femur to access the hip joint. This allows the surgeon to directly view the internal region that is causing pain and safely dislocate the hip while leaving all of the surrounding muscles intact. After repairing the abnormality the surgeon uses screws to hold the cut bone together and promote healing. A hip distraction surgical procedure typically takes about two to three hours. I have designed a specific device for this use and when indicated and performed early can be a way to save a hip.

After surgery, the patient is placed in a special bed with an attached frame to help them move on and off the bed. The incision is dressed and ice packs are applied over the hip to prevent swelling and decrease post-operative pain. The patient may spend two to three nights in the hospital but would typically be discharged once they are able to walk with the help of crutches and are eating and drinking normally. Physical therapy may be recommended to strengthen the muscles and speed up recovery.

RISKS

  • Avascular necrosis
  • Deep vein thrombosis (DVT)
  • Femoral neck fracture
  • Hardware complications
  • Infection
  • Neurovascular injury

Sources

  1. Taylor, T., (n.d.). Hip Joint. InnerBody.com. Retrieved on July 28, 2014, from http://www.innerbody.com/image/skel15.html
  2. Gomez, J., Matsumoto, H., Roye, D., Vitale, M., Hyman, J., van Bosse, H., Feldman, D.S. et al. (2009) Articulated Hip Distraction: A Treatment Option for Femoral Head Avascular Necrosis in Adolescence. Journal of Pediatric Orthpedics, 29(2), 163-9. Retrieved on July 28, 2014, from http://www.ncbi.nlm.nih.gov/pubmed/19352242
  3. Aldegheri, R., Trivella, G., Saleh, M. (1994, April) Articulated Distraction of the Hip. Conservative Surgery for Arthritis in Young Patients. Clinical Orthopedics & Related Research, (301), 94-101. http://www.ncbi.nlm.nih.gov/pubmed/8156703
  4. Perthes and Adolescent Avascular Necrosis of Hip. (n.d.). Lifebridgehealth.org. Retrieved on July 28, 2014, from http://www.lifebridgehealth.org/RIAO/PerthesandAdolescentAvascularNecrosisofHip.aspx