How effective is osteotomy for avascular necrosis of the hip?

Avascular necrosis means reduced blood supply has injured bone, commonly at the rounded top of the thigh bone. An osteotomy cuts and repositions bone so a healthier area can take more of the load. This is a demanding joint-preserving procedure and is not suitable for every hip.

The likely benefit is influenced by the size and position of the damaged area, the amount of collapse, cartilage condition, age, activity needs and the other hip. It may lessen pain or delay joint replacement in an appropriate situation, but it cannot restore dead bone to normal.

Your orthopaedic surgeon may use examination and imaging to map the damaged area and check alignment. Ask how the proposed cut would change force through the hip and what alternatives fit your stage of disease. Recovery usually includes protected weight-bearing, followed by physiotherapy to restore strength, balance and walking control.

Follow weight-bearing instructions carefully, use prescribed walking aids and attend rehabilitation appointments. Report increasing pain, wound concerns or new swelling rather than pushing through a sudden change. The return to work, driving and sport depends on healing and the demands of each activity.

Contact the surgical team promptly for fever, increasing redness or drainage from the wound, calf swelling, chest pain, breathlessness, or pain that suddenly becomes severe. Before surgery, rapidly worsening hip pain or a new inability to bear weight needs timely assessment.

Has the femoral head collapsed? What part of the hip would the osteotomy load? What is the rehabilitation and weight-bearing plan? Which alternatives should I compare, and what would make joint replacement more appropriate?