Surgical Techniques

The various techniques of preserving surgery are effective means to correct congenital or acquired hip deformities (see section "What benefits does hip preserving surgery bring?"). Should be applied according to the deformity of the hip and should not rely solely on the surgeon's preference. While in some cases the indications are still evolving, we know assuredly that:

• Conservative surgery treats the symptoms.
• Patients who benefit most are those who do not have significant degenerative joint changes.
• The surgery is more effective in younger ages.
• Each case must be individually assessed carefully since the solution is highly customizable.
• The learning curve of these techniques is long and demanding and should be performed by an experienced surgeon with specific training in hip preserving surgery.
• It is not established that in a definitive way will prevent progression to hip osteoarthritis but it may delay the appearance of it.

There are some complications described which, although not frequent, the patient should know and discuss the risks with his / her doctor.

Complications inherent in any hip surgery:

• Thrombosis of veins of the lower limbs, pulmonary thrombosis may occur even though the preventive treatment was conducted with anti-coagulant.
• Surgical wound infection and of the deeper tissues.
• Damage to nerves or to the arteries of the thigh.

Inherent complications to hip preserving surgery (surgery without prosthesis placement):

• Pseudarthrosis osteotomies (bone not consolidating where the cut took place) forcing a re-intervention.
• Failure of the screws used in bone fixation.
• Bone necrosis of the femoral head and eventually having to place a hip replacement (very rare complication).

Complications related to the surgical insertion of total hip replacement prosthesis (primary or revision):

• Limb length discrepancy – There may be a need to lengthen the limb to improve stability of the prosthesis placed.
• Instability of the prosthesis – there is always the risk of disarticulation of the two components of the prosthesis especially in situations of excessive movement with respect to what the prosthesis enables. To correct this situation may even be required a re-intervention.
• Infection of implants that may occur in the immediate postoperative period or even months / years later – this complication usually requires re-intervention for removal of infected tissues or even temporary and/or permanent removal of the implants
• There may be mechanical failure of implants used in joint replacement involving their replacement by new ones.

The complications described are universal in the available literature as likely, despite the care and experience of the surgeon. In general, the higher the surgeon´s experience the lower the complication rate will be.