What is Femoral Osteotomy?

A femoral osteotomy (FO) is a surgical procedure in which a surgeon cuts into the femur and repositions it before pinning it in place. This surgery is used to treat a number of conditions, including congenital and acquired hip deformities. It has been utilized since the early 20th century, and although it is less popular than it once was, femoral osteotomy may be considered as a treatment option for certain conditions. It requires a skilled surgeon, usually an orthopedic surgeon who specializes in surgeries which involve the bone.

For people up on their medical Latin and Greek, the name of this condition is fairly self explanatory. The femur is the thigh bone, the large bone which connects the knee to the hip sockets. “Osteo” is anything involving bone, while a “-tomy” is a medical procedure in which cutting is involved, making an “osteotomy” a surgery in which someone cuts through or into bone, in this case, the femur.

In a femoral osteotomy, the surgeon makes a long incision along the upper thigh, detaching some of the musculature in the area to reach the femur. Then, he or she cuts the bone and repositions it as needed, pinning the bone in place with a metal plate. An FO may involve a simple repositioning of the femur, or an alteration of the fundamental shape of the bone. Around the hip joint, the shape of the femur may be changed to correct a deformity.

In the weeks following a femoral osteotomy, the patient will need to use crutches, and physical therapy may be required to gain strength in the leg. A cast is not needed, as the bone is held in place with the plate. In follow up examinations, the leg will be x-rayed to confirm that it is healing as desired, and eventually a surgery to remove the plate will be scheduled. This surgery is optional, although many surgeons recommend it.

Like any surgery, a femoral osteotomy carries some risks. The patient may experience an adverse reaction to anesthesia, or the surgeon may encounter an unexpected problem when he or she opens up the leg. Infection can also set in after the surgery. There is also a risk of developing avascular necrosis, a condition in which the blood supply to the bone is interrupted, causing the bone to die. This can cause severe and permanent damage which may lead to disability for the patient. A competent surgeon will discuss all of these risks with the patient before the surgery, and work to minimize them at every step of the way.