Osteotomy as an aid to arthrodesis of the hip.

The painful hip continues to present a serious therapeutic problem. Arthroplasty has its uses, especially in bilateral disease, but has not proved a panacea ; far too many patients have persistent pain. Arthrodesis has stood the test of time. Its advocacy may be somewhat old-fashioned, hut when fusion occurs, hip pain is abolished and stability is assured. These are weighty advantages. After successful arthrodesis, if a patient complains at all, it is not of the stiffness. He may complain of symptoms in the back or knee but not in the hip itself, provided the joint is soundly fused and is in good position. With a sound arthrodesis the patient walks in comfort for long distances. He has but little limp, can sit reasonably well and, if knee flexion is good, can put on his socks and shoes ; above all, he has no pain. Because a successful arthrodesis is so good, it is worth considering its disadvantages and trying to obviate them. In the following discussion only non-tuberculous hips are considered.