Triple Pelvic Osteotomy

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Triple Pelvic Osteotomy (TPO) is an operation to realign the hip socket in patients who have a hip socket that is too shallow.
This condition is called developmental dysplasia of the hip (DDH) and is present from childhood.

Having a shallow hip socket means less of the ball of the hip is covered by the socket and this can lead to pain and ultimately osteoarthritis.
Fig 1: X-ray showing a dysplastic left hip with the shallow socket not covering the femoral head.
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The treatment for osteoarthritis is hip replacement, which should be avoided if possible, in young patients.
Moving the hip socket to cover more of the ball can relieve pain and delay the need for future hip replacement. The hip socket is made up of three bones; the pubis at the front, the ischium below and the ilium above.

In a TPO all three are cut close to the socket so that it can be repositioned. The socket is fixed into its new position with screws.
Fig 2: The same patient after TPO showing the femoral head now well covered by the socket.
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The procedure is performed with two skin incisions—one on the buttock, the other in the groin and takes around two hours.

After the surgery patients can mobilise straight away with crutches and partially weight bear for the first six weeks. By three months most patients are walking well without crutches. However it may take 12 months to recover completely.
See the most frequently asked questions about hips.
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