In India, which should be doing more of these surgeries owing to poverty and huge burden of cases, these procedures are now not common as far as I know of.

Part of the reason is retirement or demise of seasoned practitioners or teahers who excelled in it and the broken chain of legacy. Younger lots are not trained well or many have seldom seen a case thus are deprived of the procedures that were excellent in select cases.

Also, newer editions of surgical texts come with deleted chapters on various osteotomies, not particularly that of hip, as they feature newer technology and surgical advances more.

In conferences also the topics of hip and other osteotomies are relatively few and far between.

These are one of the few reasons these cases have witnessed dip in recent times in my opinion.

Thank you Dr. Ganesh for your proper post. I agree with you entirely. In my aćtive times I always preferred to perform Chiari osteotomy in early hip OA instead THR. And I am sure this practice was correct. Nowadays, these osteotomies are rarely done. However, there is a modern trend of joint preservation surgery. One can only expect a renaissance of correction hip osteotomies.

I believe that in younger age somebody can perform such osteotomies and definitely the dysplastic joints are still a reason to do such procedure. Despite this our improvement to the understanding of replacements and the improved materials as well as (to be cynical) the market made these a very rare presence in everybody's armatorium.

George, I agree with your considerations entirely. Nevertheless, I would prefer my patients to walk 10 years more on their own natural hips, and then on artificial ones. I think hip replacement is the easy way but not always the right one. However, financial interest is playing a special role. It is sad.

My dear Panayot I agree with you, but a lot of the today's practices are linked with the "needs" created by the Industry (pharmacological or implants). It is very sad; I agree.