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A hip osteotomy is a surgical procedure in which the bones of the hip joint are cut, reoriented, and fixed in a new position (with pins). Healthy cartilage is placed in the weight-bearing area of the joint, followed by reconstruction of the joint in a more normal position.

A hip osteotomy is performed under general anesthesia. Once the patient has been anesthetized, the surgeon makes an incision to expose the hip joint. The surgeon then proceeds to cut away portions of damaged bone and tissue to change the way they fit together in the hip joint. This part of the procedure may involve removing bone from the femoral head or from the acetabulum, allowing the bone to be moved slightly within the joint. By changing the position of these bones, the surgeon tries to shift the brunt of the patient's weight from damaged joint surfaces to healthier cartilage. He or she then inserts a metal plate or pin to keep the bone in its new place and closes the incision.

The surgeon removes the femoral head and neck through an incision over the hip joint. He or she then inserts an angled shaft with a smooth, balled implant into the bone. The next step is to smooth out the socket side of the joint and fit it with a cup. Depending on the type of artificial joint being used, the cup will either be cemented into place with bone cement or left uncemented. The cementless joint is made in such a way that the bone naturally grows into the surface to keep it in place.