Open Hip Osteochondroplasty (Surgical Hip Dislocation)

⚙️What This Procedure Involves

An incision is made over the lateral hip. The greater trochanter is cut (trochanteric flip osteotomy) and reflected to expose the hip capsule. The hip is carefully dislocated using a technique that preserves the blood supply to the femoral head (the Ganz approach). With the hip fully exposed, cam and pincer impingement is corrected, labral tears repaired, and cartilage damage addressed under direct vision. The hip is relocated, the trochanter repaired with screws, and the wound closed. The operation takes two to three hours.

💡Why It May Be Recommended

Surgical hip dislocation is recommended for complex FAI not fully addressable arthroscopically — such as posterior cam lesions, femoral head osteochondral defects, labral reconstruction, and combined cam-pincer impingement with large lesions. It provides unparalleled access to the entire joint.

⚖️Non-Operative Alternatives

Physiotherapy, activity modification, injection. Hip arthroscopy is the main surgical alternative and is appropriate for most FAI cases.

📋Preparing for Surgery

CT with 3D reconstruction and MRI arthrogram. This is a specialist procedure performed at selected centres.

✅Expected Benefits

Complete correction of impingement lesions with direct visualisation. Excellent outcomes in experienced hands. Joint preservation and delay or prevention of arthritis.

⚠️Common Risks

• Trochanteric non-unionUncommon

  The trochanteric osteotomy may fail to heal. Risk approximately 2–5%.

• Heterotopic ossificationUncommon

  Unwanted bone formation. Preventive medication is given.

• Lateral hip numbnessCommon

  Lateral femoral cutaneous nerve.

• Prolonged recoveryExpected

  Longer than hip arthroscopy.

🔴Less Common but Serious Risks

• Avascular necrosisRare

  The technique is designed to preserve blood supply, but AVN is a rare risk.

• Trochanteric non-union requiring revisionUncommon

  May need re-fixation or bone grafting.

• Deep infectionRare

  Wound or joint infection.

• DislocationRare

  Very rare with proper technique.

• Sciatic nerve injuryRare

  Rare.

💉Anaesthetic Considerations

General anaesthesia. Lateral decubitus position.

🏃Recovery and Rehabilitation

Crutches for six to eight weeks (trochanteric osteotomy must heal before active abduction). Restricted weight-bearing for six weeks. No active abduction for six weeks. Physiotherapy from two weeks. Return to sport at four to six months. Full recovery six to twelve months.

📅Follow-Up

X-rays at six weeks, three months, and six months. Assessment of trochanteric healing.

❓Frequently Asked Questions