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Ospedale Santa Maria, founded in 1969 and accredited by the Italian Health Service, offers specialized orthopedic care including total hip replacement for developmental dysplasia of the hip. Prof. Giuseppe Speziale, a cardiac surgeon with expertise in minimally invasive techniques, leads the department and has received the \"Top Doctors Awards\" in 2021.

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The procedure revises an old hip implant, improving mobility and reducing pain, with modern surgical techniques and materials.

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This procedure replaces a malformed hip joint, improving mobility and reducing pain for those with hip dysplasia.

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Osteotomy extends restrictions."},"final_result_months":{"min":6,"max":12,"unit":"months","qualifier":"Maximal functional recovery and pain relief after primary THA; may be longer after osteotomy."},"fly_home_after_days":{"min":14,"max":42,"unit":"days","qualifier":"Uncomplicated primary THA without osteotomy, after surgeon clearance; long-haul flights need thromboprophylaxis and are later in higher-risk cases."},"follow_up_visits":[{"purpose":"wound_check","requirement":"routine","after":{"min":10,"max":21,"unit":"days","qualifier":"Wound check and suture or staple removal if non-absorbable closure used."}},{"purpose":"assessment","requirement":"routine","after":{"min":42,"max":90,"unit":"days","qualifier":"Clinical and radiographic review."}},{"purpose":"result_review","requirement":"routine","after":{"min":300,"max":400,"unit":"days","qualifier":"About 1-year review with radiographs."}}],"indications":["Symptomatic advanced hip osteoarthritis secondary to adult developmental dysplasia","Failed conservative management with pain and functional limitation","Crowe I-IV subluxated or dislocated hips; joint preservation unsuitable"],"main_risks":["Infection","Venous thromboembolism","Dislocation","Leg length discrepancy","Sciatic or femoral nerve injury, higher with lengthening","Periprosthetic fracture","Component loosening or wear","Heterotopic ossification","Bleeding","Anesthesia-related risks","Trochanteric or osteotomy-site nonunion","Iliopsoas impingement","Vascular injury","Abductor weakness or Trendelenburg gait"],"pain":"Moderate to significant pain in the first days, controlled with multimodal analgesia; improves over several weeks and arthritic pain is usually substantially relieved.","preparation":["Preoperative medical assessment and clearance","Pelvis and hip radiographs; CT for severe dysplasia","Templating of cup center of rotation and leg length","Fasting before anesthesia as instructed","Medication review with surgical team","Smoking cessation","Infection screening","Weight optimization","Home and rehabilitation planning with preoperative exercises","Disclosure of prior hip surgery or hardware"],"recovery_timeline":[{"phase":"Hospital stay (days 0-4)","description":"Early mobilization with physiotherapy, pain control and thromboprophylaxis.","restrictions":["Use walking aid","Follow surgeon's hip precautions"]},{"phase":"Weeks 1-6","description":"Progressive walking with crutches or frame, wound healing, basic strengthening; weight-bearing may be restricted after osteotomy.","restrictions":["No driving until cleared","Avoid extreme hip flexion and rotation if precautions advised"]},{"phase":"Weeks 6-12","description":"Walking without aids, strengthening and gradual return to light work.","restrictions":["Avoid impact activities"]},{"phase":"Months 3-12","description":"Continued strengthening and functional gains toward final result.","restrictions":["Avoid high-impact sports"]},{"phase":"At any time","description":"Seek urgent care for fever, wound discharge, calf swelling, chest pain, breathlessness, sudden severe hip pain, inability to bear weight, or new leg numbness.","restrictions":[]}],"rehabilitation_days":{"min":42,"max":90,"unit":"days","qualifier":"Ordinary functional recovery to independent walking and daily activities; longer after osteotomy or restricted weight-bearing."},"result_longevity":"Implants often function 15-20+ years; longevity depends on implant, bearing, age, activity and bone quality, and younger dysplasia patients have higher lifetime revision likelihood.","revision_rate_pct":{"min":3,"max":10,"unit":"percent","qualifier":"Revision at about 10 years after primary THA for DDH; higher in Crowe III-IV and younger patients."},"scars":"A single hip incision, typically 10-20 cm, fading to a linear scar; longer if osteotomy is performed.","sessions_or_stages":{"sessions":{"min":1,"max":1,"unit":"visits","qualifier":"Single operation on one hip; bilateral cases are usually staged separately."},"stages":[{"code":"surgery","label":"Primary THA with acetabular and femoral reconstruction","after":{"min":0,"max":0,"unit":"days","qualifier":"Day of surgery."}}],"qualifier":"One-stage unilateral primary THA."},"success":{"metric":"Implant survival free of revision","value":90,"unit":"percent","horizon":"10 years","population":"Adults with symptomatic hip osteoarthritis from DDH undergoing primary THA; lower in Crowe III-IV","evidence_status":"limited"},"techniques":[{"name":"Primary THA with cup at true acetabulum, often small cementless components","suits_whom":"Crowe I-II and most Crowe III hips with adequate bone stock.","recovery":"Standard rehabilitation with weight-bearing as tolerated."},{"name":"THA with femoral shortening osteotomy (e.g., subtrochanteric)","suits_whom":"Crowe III-IV high dislocations needing reduction without excess nerve stretch.","recovery":"Often protected weight-bearing for several weeks; longer overall recovery."},{"name":"THA with acetabular bone grafting or augmentation","suits_whom":"Hips with deficient acetabular coverage.","recovery":"May need temporary restricted weight-bearing."}],"treatment_conditions":["inpatient"],"treatment_duration_hours":{"min":1.5,"max":3.5,"unit":"hours","qualifier":"Operative time for unilateral primary THA without osteotomy; longer with femoral osteotomy or grafting."},"initial_assessment_documents":["Standing AP pelvis X-ray","Lateral X-ray of affected hip","Pelvis or hip CT scan (if available)","Previous hip surgery operative reports (if available)","Recent blood test results and ECG","List of current medications including blood thinners"],"travel_trips":{"min":1,"max":2,"one_trip_possible":true,"qualifier":"Single-stage surgery; stay 14-21 days until wound check and flight clearance. Second trip only for in-clinic 6-12 week review."},"clinic_checks":{"status":"ok","items":[{"id":"C1","text":"Check that your surgeon explains the risks and complications of the operation","scope":"procedure","source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement/","host":"orthoinfo.aaos.org","quote":"In addition, your orthopaedic surgeon will explain the potential risks and complications of total hip replacement surgery, including those related to the surgery itself and those that can occur over time after your surgery.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C2","text":"Check the qualifications of the medical team that will treat you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you checked the qualifications of the medical team treating you?","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C3","text":"Check that you are able to ask the team questions about your treatment","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Have you been able to ask them questions about your treatment?","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C4","text":"Check that the clinic or hospital facilities and standards satisfy you","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Are you satisfied with the facilities and standards at the clinic or hospital where you'll be treated?","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C5","text":"Get a second opinion from a doctor about the treatment and whether it is necessary","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"A doctor can give you a valuable second opinion as well as advice about treatment options and whether it's necessary.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"C6","text":"Check how your aftercare will be coordinated","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"Ensure you're clear about how your aftercare will be coordinated.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"red_flags":{"status":"ok","items":[{"id":"F1","text":"Pressure to make a quick decision is a warning sign before booking treatment abroad","scope":"treatment_abroad","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/going-abroad-for-treatment/treatment-abroad-checklist/","host":"nhs.uk","quote":"pressure to make a quick decision","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"F2","text":"An advert or information that guarantees complete success should raise concerns","scope":"treatment_abroad","source":{"url":"https://travelaware.campaign.gov.uk/surgery-abroad-cut-out-the-risk/","host":"travelaware.campaign.gov.uk","quote":"Any advert or information that guarantees complete success should raise concerns.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"F3","text":"A price that sounds too good to be true probably is","scope":"treatment_abroad","source":{"url":"https://www.plasticsurgery.org/news/articles/will-economic-uncertainty-drive-more-patients-overseas-for-plastic-surgery-what-to-consider-and-how-to-stretch-your-dollar-back-home","host":"plasticsurgery.org","quote":"If the price sounds too good to be true, it probably is.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"warning_signs":{"status":"ok","items":[{"id":"W1","text":"Hip ball coming out of socket","urgency":"contact_clinic","general":false,"source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement/","host":"orthoinfo.aaos.org","quote":"This occurs when the ball comes out of the socket.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W2","text":"Calf pain unrelated to the incision","urgency":"contact_clinic","general":false,"source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement?grpwebid=26DAE356","host":"orthoinfo.aaos.org","quote":"Pain in your calf and leg that is unrelated to your incision","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"W3","text":"New or increasing leg swelling","urgency":"contact_clinic","general":false,"source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement?grpwebid=26DAE356","host":"orthoinfo.aaos.org","quote":"New or increasing swelling of your thigh, calf, ankle, or foot","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"take_home":{"status":"ok","items":[{"id":"T1","text":"Keep discharge documents for continuing care after treatment","document":"discharge documents","source":{"url":"https://www.nhs.uk/using-the-nhs/healthcare-abroad/apply-for-a-free-uk-global-health-insurance-card-ghic/","host":"nhs.uk","quote":"Keep all documents relating to your treatment.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},{"id":"T2","text":"Ask for written details of the procedure before you leave the hospital","document":"written procedure details","source":{"url":"https://rcseng.ac.uk/patient-care/cosmetic-surgery/after-surgery/","host":"rcseng.ac.uk","quote":"After your surgery, before you leave the hospital, ask for written information about the procedure you've had.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T3","text":"Ask for copies of all prescriptions before you leave","document":"prescription copies","source":{"url":"https://travelhealthpro.org.uk/news/699/travelling-abroad-for-treatment","host":"travelhealthpro.org.uk","quote":"Remember to ask for copies of all your treatment records, including prescriptions, scans and x-rays before you leave.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}},{"id":"T4","text":"Home doctor needs the dates for required blood tests and follow-up appointments","document":"written aftercare plan","source":{"url":"https://sbuhb.nhs.wales/about-us/individual-patient-commissioning/ipc-folder/advice-on-accessing-treatment-abroad","host":"sbuhb.nhs.wales","quote":"This should include any medication and doses, as well as any dates that blood tests and follow-up appointments must be carried out.","tier":"tier1_medical","fetched_at":"2026-11-11","http_status":200}}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"alternatives":{"status":"ok","items":[{"id":"A1","text":"Your hip dysplasia is mild with no labrum or cartilage damage","name":"Nonsurgical treatment","source":{"url":"https://orthoinfo.aaos.org/en/diseases--conditions/adolescent-hip-dysplasia","host":"orthoinfo.aaos.org","quote":"Your child's doctor may recommend nonsurgical treatment if your child has mild hip dysplasia and no damage to the labrum or articular cartilage.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200},"operation_id":null}],"checked_at":"2026-11-14","next_check_at":"2027-11-14","version":1},"technique_details":{"status":"ok","items":[{"id":"primary-tha","name":"Primary THA with cup at true acetabulum, often small cementless components","how_it_works":{"text":"The damaged socket is replaced with a metal socket","source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement/","host":"orthoinfo.aaos.org","quote":"The damaged cartilage surface of the socket (acetabulum) is removed and replaced with a metal socket.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}},"recovery_daily":{"event":"back_to_daily_activities","min":3,"max":6,"unit":"weeks","label":"3–6 weeks","source":{"url":"https://orthoinfo.aaos.org/en/treatment/total-hip-replacement?grpwebid=26DAE356","host":"orthoinfo.aaos.org","quote":"You should be able to resume most normal light activities of daily living within 3 to 6 weeks following surgery.","tier":"tier1_medical","fetched_at":"2026-11-14","http_status":200}}},{"id":"tha-femoral-shortening","name":"THA with femoral shortening osteotomy (e.g., subtrochanteric)","how_it_works":{"text":"A subtrochanteric osteotomy accompanies hip replacement for severe dysplasia","source":{"url":"https://www.aaos.org/videos/video-detail-page/?id=27534__Videos&cc=OVT","host":"aaos.org","quote":"Total hip arthroplasty with a subtrochanteric osteotomy can provide improved pain and function in patients with severe hip dysplasia.","tier":"tier1_medical","fetched_at":"2026-11-12","http_status":200}},"recovery_daily":{"status":"missing","reason":"no_official_source"}},{"id":"tha-acetabular-bone","name":"THA with acetabular bone grafting or 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