Cheilectomy of the hip.

Cheilectomy is an excellent procedure for salvaging decompensated hips in childred aged 10 to 14 years when certain indicators are present: coxa magna and plana, a completely ossified epiphysis, an open physis, and a well preserved cartilage space. Accurate assessment in these cases is extremely important, since a combination of surgical procedures may be necessary. The cheilectomy will correct deformities of the femoral head only; if inadequacies exist in the acetabulum, a pelvic osteotomy must be performedwhile transfer of the greater trochanter is required when the trochanter exhibits cephalad movement or the femoral neck is short. Postoperative treatment is the most critical element of the process, requiring careful and thorough evaluation of results and immediate attention to any loss in the patient's range of motion. Although the relative newness of the procedure presently makes impossible any claims about its permanent efficacy, follow-up reports in patients who have undergone the surgery indicate that the cheilectomy can yield long term beneficial results. And in the decompensated hip, even if the problems are alleviated for only a 10 to 15 year period, the surgery has been worthwhile.