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Hip Joint Surgery what happens to the hip bone?

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My daughter is diagnosed with cerebral palsy & scoliosis. She is having extreme hip pain due to the hip constantly staying out of socket which causes her left leg to cross over the right. Her spine surgeon is recommending a surgery that will sever the femur head. My question is what happens to the hip bone? Will it not be connected anymore?
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replied January 5th, 2012
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You do not say how old your daughter is and if she is ambulatory or not. Is she able to walk on her own or is she wheelchair bound?

There are several procedures which can be done, to help keep the femoral head located in the joint, depending upon the age of the patient, how severe the hip dysplasia is, and if the patient is ambulatory.

These can include such procedures as:
- just a release of tendons
- a VDRO (varus derotational osteotomy) which is where the proximal femur is cut, rotated so the head is pointing into the socket, and then plated to hold it
- an acetabular osteotomy, where the acetabulum (socket) is repositioned so that the femoral head stays in the joint
- a combination of the above procedures
- resection arthroplasty (Girdlestone procedure or variant), which is only done in nonambulatory patients, this is where the femoral head is removed; this produces a flail joint, but allows the patient to be seated better, without pain

So, again, the choice of procedures depends upon a lot of factors.

But, if your daughter is supposed to have a resection of the femoral head (removing the femoral head), that will result in a flail joint. There will be no bony connection. The area where the joint used to be fills in with scar tissue. So, instead of a mechanical bony joint, the connection becomes one of soft scar tissue. Since there is no longer a joint there, the bones aren't rubbing on each other, so the pain is less.

This procedure is usually only done is pretty significantly involved cerebral palsy children. It is done, essentially, only for pain control.

You should discuss the surgery with the surgeon who will doing the procedure. Be sure to get all of your questions answered. Good luck.
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