What is hip dysplasia?

We have all known some case of a newborn that the pediatrician explains to the family that the hips “go out of place” and that you have to apply several diapers or even a harness so that the legs stay open and thus the heads of the femur remain inside the acetabulum in the first months.
In some cases over the years these heads are not completely inside the acetabulum and do not hold up well, tending the head to escape. This situation causes the hip to wear out faster than what is considered normal with age. They are often 20-30 year old people with pain at all physical exertions. If not treated in time with corrective operations of these bones will develop a wear on the joint that we know as osteoarthritis.

A very typical deformity is the one that occurs as a result of an alteration of the growth of the hip because the circulation of these bones in the growth fails. It is about the Legg-Perthes-Calvé disease. In the end we find a situation very similar to that of dysplasia and that we will have to face with the utmost promptness. In both cases, the sooner we correct these bones, the longer term results are better.

Treatment of hip dysplasia

In all cases the treatment consists in normalizing the situation giving coverage to the femoral head. In children there are different surgical techniques to be able to replace it. In the young adult, depending on each type of dysplasia, either coverage can be increased (Chiari osteotomy) or by changing the orientation of the acetabulum (three-dimensional periacetabular Ganz osteotomy). Our center is a reference in this pathology. Our teacher Prof. Vilarrubias was in the seventies the introducer in Spain of the Osteotomy of Prof. Chiari of Vienna and Dr. Manuel Ribas, the first to perform the Ganz Osteotomy in Barcelona, ​​which he is currently performing with a minimally invasive approach.

Dr. Manuel Ribas is the surgeon in Spain with the most experience in Periacetabular Osteotomy of Ganz with more than 100 cases, which has allowed him to perform it by mini-invasive. The mini-invasive route involves intraoperative bleeding three times lower than the conventional route described by Prof. Reinhold Ganz himself and a faster postoperative recovery. Different athletes affected by moderate dysplasia have benefited from this technical variant. Nowadays it is demonstrated that Ganz’s periacetabular osteotomy, which maintains the contact of natural cartilage between the acetabulum and the femur, really diminishes in a very manifest way the evolution towards osteoarthritis in these patients and, consequently, the need to implant them in a medium term future a hip prosthesis.

In some cases it is necessary to correct the femur to be able to normalize the situation of the hip. One of the techniques that has given us the most success is the osteotomy of retraining of the femoral neck of Vilarrubias.

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