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Surgical Technique: Proximal Femoral Osteotomies in Residual Childhood Disease

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Hip Arthroscopy and Hip Joint Preservation Surgery

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Abstract

The proximal femoral osteotomy is an instrumental tool for hip deformity correction. The goal of a proximal femoral osteotomy is to return the patients’ abnormal morphology to an anatomic alignment of the proximal femur. Proximal femoral osteotomy has also been used to change the otherwise normal proximal femoral anatomy in such a way to positively benefit the hip joint through improved mechanics as well as correct global femoral malrotation.

Proximal femoral osteotomy has been used to address problems such as severe slipped capital femoral epiphysis disease, Legg-Calvé-Perthes disease, developmental dysplasia of the hip, congenital malrotation, and posttraumatic malunion of the proximal femur.

The decision to operate with a proximal femoral osteotomy is driven by patient symptoms in conjunction with altered proximal femoral anatomy and alignment. Plain radiographs and long leg alignment imaging are the key diagnostic imaging techniques when planning a proximal femoral osteotomy. The indications for surgical intervention are poorly defined by previous literature and require a complete assessment of the patient’s symptoms and diagnostic imaging.

Recently there has been renewed interest and development of new techniques of proximal femoral osteotomy to more directly address pathoanatomy. Focused research on the vascular supply to the femoral head has provided the opportunity to directly treat hip deformity that previously would have been left to natural history and inevitable coxarthrosis [1]. While these new techniques have engendered considerable interest, the long-term outcomes are not available at this point. The techniques described in the following chapter are among the most technically challenging in all of orthopedic surgery.

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Author information

Authors and Affiliations

  1. Orthopaedic Chief Resident, Naval Medical Center, San Diego, USA

    Brian T. Barlow

  2. Faculty, Orthopedic Department, University Hospital Dusseldorf, Moorenstr. 5,40225,, Dusseldorf, Germany

    Bernd Bittersohl

  3. San Antonio Military Medical Center, Ft. Sam Houston, Houston, TX, USA

    Matthew Schmitz

  4. Sharp Grossmont Hospital, La Mesa, Paradise Valley Hospital, National City, 2023 W. Vista Way, Suite B, Vista, 92083, CA, USA

    Harish S. Hosalkar

Authors
  1. Brian T. Barlow
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  2. Bernd Bittersohl
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  3. Matthew Schmitz
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  4. Harish S. Hosalkar
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Corresponding author

Correspondence to Brian T. Barlow .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois, USA

    Shane J. Nho

  2. Department of Orthopaedic Surgery, Schulthess Klinik, Zurich, Switzerland

    Michael Leunig

  3. Minnesota Orthopedic Sports Medicine Institute, Twin Cities Orthopedics - Edina, Edina, Minnesota, USA

    Christopher M. Larson

  4. Department of Orthopaedics, University of Michigan, Ann Arbor, Michigan, USA

    Asheesh Bedi

  5. Sports Medicine and Shoulder Service and Center for Hip Preservation Surgery, Hospital for Special Surgery, New York, New York, USA

    Bryan T. Kelly

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Barlow, B.T., Bittersohl, B., Schmitz, M., Hosalkar, H.S. (2015). Surgical Technique: Proximal Femoral Osteotomies in Residual Childhood Disease. In: Nho, S., Leunig, M., Larson, C., Bedi, A., Kelly, B. (eds) Hip Arthroscopy and Hip Joint Preservation Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6965-0_39

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  • DOI: https://doi.org/10.1007/978-1-4614-6965-0_39

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6964-3

  • Online ISBN: 978-1-4614-6965-0

  • eBook Packages: MedicineReference Module Medicine

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