Femoral Osteotomy: Anteversion, Retroversion, Surgery

Overview

• Femoral osteotomy: Surgical procedure to correct deformities of the femur and hip joint.
  • Performed by orthopedic surgeons.
  • Involves cutting and realigning the bone.
  • Addresses/prevents issues like cartilage damage, labrum tears, and hip impingement.

Understanding Hip Anatomy

• Hip Joint: Ball and socket joint where femur meets pelvis.
• Femur: Longest bone, supports leg alignment.
• Femoral Neck: Curves forward, connects to pelvis.
• Acetabulum: Socket in the pelvic bone.
• Articular Cartilage: Cushions joint surfaces.

Femoral Version Deformities

• Version: Angle of femoral neck to femur shaft.
  • Normal: 12-15 degrees forward.
• Anteversion: Neck rotated too far forward.
  • Leads to in-toeing gait, discomfort, risk of labrum tears, arthritis.
• Retroversion: Neck rotated too far backward.
  • Leads to out-toeing gait, increased impingement, pain.

Hip Joint Abnormalities

• Hip Impingement: Contact between femoral head and acetabulum.
  • Types: Cam (femoral neck) and Pincer (acetabulum).
• Acetabulum Abnormalities: Excessive anteversion or retroversion.
• Neck-Shaft Angle Abnormalities:
  • Coxa Vara: Decreased angle.
  • Coxa Valga: Increased angle.

Occurrence and Diagnosis

• More common in women, can be congenital or due to trauma.
• Symptoms: Pain, walking difficulties, labral tears, arthritis.
• Diagnostic process: Patient history, physical exam, MRI, CT scans.
• CT and 3D models for surgical guidance.

Treatment Options

• Arthroscopic Procedures: Minimize invasive techniques to address issues.
• Correction of Neck-Shaft Angle: Via osteotomy and bone fixation.
• Minimally Invasive Surgery: For rotational deformities.

Rehabilitation and Outcomes

• Rehabilitation: Monitored joint motion, weight-bearing, strengthening.
• Collaboration: HSS specialists address complex conditions.
• Advancements: Improved understanding and treatment of hip conditions.
• Importance of Early Recognition: Essential to seek specialist care.

Experts and Related Information

• Robert L. Buly, MD: Chief Emeritus, Hip Preservation Service, Hospital for Special Surgery.

Related Articles

• Hip Joint Pain and Preservation: An Overview