Understanding Femoral Osteotomy and Its Implications

May 1, 2025

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.

Normal anatomy of the femur and hip joints

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.

Normal Femoral Neck Anteversion Excessive Femoral Anteversion Excessive Femoral Retroversion

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.

Femoral Neck-Shaft 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.

Pelvis x-ray and 3D model

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.

Varus Derotation Osteotomy Femoral Derotation Osteotomy Technique

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.

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