The young patient hobbled into my consultation on crutches. That’s not unusual – I’m an orthopedic surgeon. However, my specialty is artificial knee and hip joints, and this patient was only in her early 20s. I was curious to know why she came to me. She said she has had seven surgeries on her right hip in the past five years. For three years she had been taking the strongest painkillers, so-called opioids, in order to be able to walk. The trigger was hip dysplasia, a congenital malformation of the hip joint. The joint socket is too small for the femoral head. The joint cartilage is overloaded and breaks down, which hurts. There is also a risk that the joint head will jump out of the socket.
In the first operations, attempts were made to build up the “articular lip” – it forms the cartilaginous edge of the bony socket. The symptoms hadn’t gone away. A “conversion osteotomy” followed. During this procedure, the hip socket is separated from the pelvis, repositioned and fixed so that it better encloses the joint head. That didn’t work out well the first time. Multiple corrective surgeries had been performed in which a major vessel and nerve had been injured.
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