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What is Proximal Femoral Osteotomy?

Proximal femoral osteotomy is a surgical procedure that involves cutting and alignment of the upper (proximal) part of the thigh bone, also called the femur. The proximal femur is part of the femur that articulates with the socket of the hip bone, called the acetabulum. Proximal femoral osteotomy helps restore hip function.

Indications for Proximal Femur Osteotomy

A proximal femoral osteotomy is recommended for the following conditions:

  • Structural defects in the hip joint or femur/femoral deformity
  • Femoroacetabular impingement or FAI
  • Severe hip pain that is not responding to conservative treatment methods

Who is Eligible for Proximal Femur Osteotomy?

You may be a candidate for proximal femoral osteotomy if you:

  • Have a healthy weight with BMI <30
  • Not older than 65 years old
  • Do not have arthritis or only have mild arthritis
  • Have had a failed total hip arthroplasty

Procedure for Proximal Femoral Osteotomy

You will lie on your back and be administered general anesthesia. An incision is made in the proximal femur near your hip joint.

  • The cut in the proximal femur is made using an oscillating saw.
  • The fascia lata muscle in your thigh and gluteus maximus muscle in your hip are incised similarly and retracted.
  • The proximal femur is exposed and a predetermined section is removed from it.
  • After the bone is removed, your surgeon may close the remaining space either by:
  • placing a graft between them or
  • by bringing the cut ends of the bones together
  • Then, the proximal femur and hip joint is aligned in correct position using metal plates, wires and screws.
  • The incision is closed and healing occurs the same way a fracture heals.

The duration of surgery maybe 2-3 hours.

Recovery from Proximal Femoral Osteotomy

After a proximal femoral osteotomy procedure, you may be required to stay in the hospital for 1 or 2 days.

  • Your surgeon and healthcare staff will monitor your progress and plan a pain management protocol to reduce your need and dose of pain medications.
  • You will be required to take up weight-bearing gradually.
  • On the second postoperative day, you will be encouraged to stand with a walker and begin touch-down weight-bearing for increasing periods of time.
  • You may require crutches for 6-8 weeks for weight-bearing.
  • It may take around 3 months to resume most of your normal activities.
  • Returning to athletics may require 6-9 months.

Benefits of Proximal Femoral Osteotomy

The benefits of proximal femoral osteotomy may include:

  • Significant reduction in hip pain
  • Improved hip joint function
  • Delays the need for hip replacement

  • American Academy of Orthopaedic Surgeons
  • American Orthopaedic Society for Sports Medicine
  • International Cartilage Regeneration and Joint Preservation Society
  • International Society for Hip Arthroscopy
  • American Association of Hip and Knee Surgeons
  • Orthopaedic Trauma Association
  • International Society of Arthroscopy, Knee Surgery and Orthopaedic Sports Medicine