Osteotomies of the hip in the prevention and treatment of osteoarthritis.

Osteoarthritis of the hip is common in our society, even in the relatively young patient. Most of this osteoarthritis is mechanical in etiology and is secondary to residual deformity from developmental hip disease. This type of osteoarthritis can often be predicted and prevented if the causative excessive joint pressures are reduced in a timely fashion by corrective osteotomy. Realigning pelvic or intertrochanteric osteotomy of this preventive type is termed reconstructive; those osteotomies performed after osteoarthritis is established are termed salvage. Corrective osteotomy will be clinically successful only if the mechanical etiology for the potential or established osteoarthritis is clear and if the osteotomy succeeds in reducing the pathologically excessive joint loads. The clinical success of osteotomy also requires precise technical planning preoperatively and careful operative technique.