Kevin's hip is not currently causing him any pain (that we know of) and it is not totally dislocated but it does not sit in the joint properly. We've been told by several doctors the importance of intervening prior to dislocation as it is much harder to maintain the hip once it has already dislocated. We were also told that pain and arthritis would be sure to set in if it's not corrected. We also hope that by de-rotating the left hip, we can correct some of the in-toeing as he walks. This procedure will likely leave his short leg even shorter.
I'm feeling more prepared and calmer going into this hip surgery after experiencing the January foot surgery. Kevin was fortunate to come home from the January surgery with a nerve block and no oral medication was needed for pain. This surgery will be different and he will have pain so I am concerned about that but I know there is nothing more I can do. My other concern is being prepared at the house for lifting and transferring him with the spica cast. I can't imagine lifting him in this awkward position, especially now that he gained ten pounds after the last surgery...but God will provide...He always does.
Thank you for your prayers for Kevin's surgery, doctor, nurses and hospital staff, and for Kevin to find some form of comfort during his recovery time.
I found a description of the surgery that I copied below from Surgery Encyclopedia.
Hip osteotomy
Definition
A hip osteotomy is a surgical procedure in which the bones of the hip joint are cut, reoriented, and fixed in a new position. Healthy cartilage is placed in the weight-bearing area of the joint, followed by reconstruction of the joint in a more normal position.
Purpose
To understand hip surgery, it is helpful to have a brief description of the structure of the human hip. The femur, or thigh bone, is connected to the knee at its lower end and forms part of the hip joint at its upper end. The femur ends in a ball-shaped piece of bone called the femoral head. The short, slanted segment of the femur that lies between the femoral head and the long vertical femoral shaft is called the neck of the femur. In a normal hip, the femoral head fits snugly into a socket called the acetabulum. The hip joint thus consists of two parts, the pelvic socket or acetabulum, and the femoral head.
The hip is susceptible to damage from a number of diseases and disorders, including arthritis, traumatic injury, avascular necrosis, cerebral palsy, or Legg-Calve-Perthes (LCP) disease in young patients. The hip socket may be too shallow, too large, or too small, or the femoral head may lose its proper round contour. Problems related to the shape of the bones in the hip joint are usually referred to as hip dysplasia. Hip replacement surgery is often the preferred treatment for disorders of the hip in older patients. Adolescents and young adults, however, are rarely considered for this type of surgery due to their active lifestyle; they have few good options for alleviating their pain and improving joint function if they are stricken by a hip disorder. Osteotomies are performed in these patients, using the patient's own tissue in order to restore joint function in the hip and eliminate pain. An osteotomy corrects a hip deformity by cutting and repositioning the bone, most commonly in patients with misalignment of certain joints or mild osteoarthritis. The procedure is also useful for people with osteoarthritis in only one hip who are too young for a total joint replacement.
Description
A hip osteotomy is performed under general anesthesia. Once the patient has been anesthetized, the surgeon makes an incision to expose the hip joint. The surgeon then proceeds to cut away portions of damaged bone and tissue to change the way they fit together in the hip joint. This part of the procedure may involve removing bone from the femoral head or from the acetabulum, allowing the bone to be moved slightly within the joint. By changing the position of these bones, the surgeon tries to shift the brunt of the patient's weight from damaged joint surfaces to healthier cartilage. He or she then inserts a metal plate or pin to keep the bone in its new place and closes the incision.
There are different hip osteotomy procedures, depending on the type of bone correction required. Two common procedures are:
- Varus rotational osteotomy (VRO), also called a varus derotational osteotomy (VDO). In some patients, the femoral neck is too straight and is not angled far enough toward the acetabulum. This condition is called femoral neck valgus or just plain valgus. The VRO procedure corrects the shape of the femoral neck. In other patients, the femoral neck is not straight enough, in which case the condition is referred to as a femoral neck varus.
- Pelvic osteotomy. Many hip disorders are caused by a deformed acetabulum that cannot accommodate the femoral head. In this procedure, the surgeon redirects the acetabular cartilage or augments a deficient acetabulum with bone taken from outside the joint.
Aftercare
Immediately following a hip osteotomy, patients are taken to the recovery room where they are kept for one to two hours. The patient's blood pressure, circulation, respiration, temperature, and wound drainage are carefully monitored. Antibiotics and fluids are given through the IV line that was placed in the arm vein during surgery. After a few days the IV is disconnected; if antibiotics are still needed, they are given by mouth for a few more days. If the patient feels some discomfort, pain medication is given every three to four hours as needed.
Patients usually remain in the hospital for several days after a hip osteotomy. Most VRO patients also require a body cast that includes the legs, which is known as a spica cast. Because of the extent of the surgery that must be done and healing that must occur to restore the pelvis to full strength, the patient's hip may be kept from bearing the full weight of the upper body for about eight to 10 weeks. A second operation may be performed after the patient's pelvis has healed to remove some of the hardware that the surgeon had inserted. Full recovery following an osteotomy usually takes longer than with a total hip replacement; it may be about four to six months before the patient can walk without assistive devices.
Risks
Although complications following hip osteotomy are rare, there is a small chance of infection or blood clot formation. There is also a very low risk of the bone not healing properly, surgical damage to a nerve or artery, or poor skin healing.
Read more: http://www.surgeryencyclopedia.com/Fi-La/Hip-Osteotomy.html#ixzz4k6v7WoSH
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