An Osteotomy is a surgical procedure wherein a bone is resized, reshaped or realigned via cutting or chipping. Accordingly, a hip osteotomy is a procedure for reshaping and reorientating the hip joint to cure problems such as hip dysplasias, arthritis and other deformities.
The hip joint consists of the acetabulum (socket part of the hip bone) and femoral head (ball-like femur bone head) bones. During an osteotomy, either one or both of these converging bone surfaces are reshaped to realign the load-bearing surfaces and change their fitting positions in the hip joint. This way, the body-weight load is skillfully shifted from the damaged joint to the healthy joint on the opposite side.
• Varus rotational osteotomy (VRO): Here, the shape of the femoral bone’s neck is altered when the femoral neck is too straight and is not correctly angled towards the acetabulum.
• Pelvic osteotomy : It is performed on a deformed acetabulum that fails to fit the femoral head. Here, the surgeon either redirects the acetabular cartilage or augments it with bone autografts to reshape the acetabulum according to the femoral head.
• Transtrochanteric Anterior Rotational Osteotomy (Sugioka Osteotomy): The Transtrochanteric Anterior Rotational Osteotomy (TRO) is a preservation-type surgery performed on the femoral head.
It was proposed by a Japanese surgeon Sugioka in 1972 and hence, is often known as Sugioka Osteotomy.
In this surgery, the necrotic part of the damaged femoral head is swapped or moved from the weight-bearing region to a non-weight-bearing surface to prevent any further cell and tissue damage and to prevent secondary osteoarthritis in young patients with osteonecrosis of the femoral head.