Femoral Osteotomy

Overview

Femoral osteotomy is a surgical procedure used to correct abnormal alignment of the femur, which can lead to joint pain, instability, or impingement. This procedure can be performed in the frontal plane to address knock-kneed or bowlegged deformities or in the axial plane to address aberrant femoral version.

Types of Femoral Osteotomies and Their Indications

• Distal Femoral Osteotomy (DFO):

  • Opening-Wedge DFO: This technique involves creating a controlled fracture in the distal femur and gradually opening the osteotomy to realign the limb. It is commonly indicated for patients with knock-kneed malalignment, especially in the setting of lateral compartment overload.

  • Closing-Wedge DFO: This involves removing a wedge of bone to correct bowlegged deformity. It is typically indicated for bowlegged malalignment contributing to medial compartment overload.

• Femoral Derotational Osteotomy (FDO):

  • This procedure is used to correct abnormal femoral version, which can cause symptoms such as hip pain, instability, or impingement. Increased femoral anteversion can lead to anterior instability and microinstability, while femoral retroversion may contribute to impingement. FDO is indicated in patients with symptomatic version abnormalities who have failed conservative management.

The Procedure

Femoral osteotomy can be performed using an open technique. The surgeon makes a controlled cut in the femur, adjusts the bone to the desired alignment, and stabilizes it with a plate or rod. For derotational osteotomies, careful preoperative planning ensures the appropriate degree of correction.

Recovery Process

Recovery involves a period of limited weight-bearing and physical therapy focused on restoring strength, mobility, and joint mechanics. Most patients can resume daily activities within 3-4 months, though full recovery may take up to a year depending on the procedure and activity level.

Risks and Considerations

Risks include nonunion, hardware irritation, infection, and nerve injury. Accurate surgical technique and adherence to post-operative protocols are crucial to minimize these risks.

Conclusion

Femoral osteotomy is an effective procedure for patients with symptomatic frontal or rotational abnormalities of the femur. If you are experiencing hip or knee pain due to malalignment, contact our office for a comprehensive evaluation and personalized treatment plan.