The hip is a ball and socket joint with the ball being formed by the head of the femur (thigh bone) and the pelvic bone forming the socket (acetabulum). The correct alignment of the femur in relation to the pelvic bone plays an important role in the proper functioning and health of the joint. Fractures, non-union of treated fractures or deformities may result in an improper relationship between these structures, leading to wear and tear (arthritis) and pain at the joint, and gait deformities.
A femoral osteotomy is a surgical procedure that involves reshaping the upper part of the femur to realign it within the socket. The correction of the hip anatomy reduces the symptoms and progression of arthritis.Before performing a femoral osteotomy, your doctor will conduct a physical examination and obtain appropriate imaging studies to identify the deformity and decide on the type of osteotomy. The conditions that commonly need a femoral osteotomy include rotational (twisting) deformity of the femur andthe residuals of pediatric hip diseases including Legg-Calve-Perthes disease (a loss of blood flow to the femoral head during childhood) and slipped capital femoral epiphysis (a fracture through the growth plate of the hip in the teenage years).
The procedure can be combined with either a surgical hip dislocation or a hip arthroscopy to address problems inside and around the hip joint.
The femoral osteotomy is performed under general combined with spinal anesthesia. Your surgeon makes an incision along the side of your hip. During the procedure, your doctor cuts the femur and realigns it correcting rotational or angular deformities. Metal plates or rods along with screws are placed to stabilize the osteotomy site until it heals.
Patients are admitted to the hospital for one or two days to make sure their pain is controlled, and they can get around safely. You are placed on crutches for about 6 weeks while the bones and soft tissues are healing. X-rays are obtained at 2 and 6 weeks after surgery to make sure that the bones are healing normally. After six weeks patients are normally progressed to start physical therapy and a full recovery takes about 6 months.
Risk and Complications
As with all surgical procedures, femoral osteotomy may be associated with certain complications such as infection, nerve and blood vessel injury, inability to achieve complete correction and persistence of pain and nonunion (the osteotomy not healing).