Surgical Hip Dislocation

One of the great challenges in the treatment of disease of the hip has been limited access to the joint. Due to the multiple powerful muscles that cross the hip and the depth of the joint, dislocation of the hip is usually the only way to access the inner portion of the joint. However, dislocation of the hip can be quite hazardous due to the tenuous blood supply of the femoral head through an artery known as the medial femoral circumflex artery (MFCA). Damage to this blood supply is a major risk factor in the development of avascular necrosis. Professor Reinhold Ganz developed a procedure for safe access to the hip through studies of the anatomy of the MFCA. This artery has been shown to travel up the back part of the neck of the femur and enter the bone at the junction of the head and neck of the femur. Surgical hip dislocation allows access to the joint by using this anatomical information and entering through the front of the joint. In this procedure, an osteotomy (surgical bone cut) is performed on the outer aspect of the femur allowing the joint to be dislocated relatively easily. This procedure provides unlimited access to all aspects of the hip and has made the treatment of cartilage damage to the hip a real possibility. Currently, the procedure has been applied to the treatment of slipped capital femoral epiphysis (SCFE), hip impingement, avascular necrosis, and severe cartilage injuries of the hip.