Femoral Osteotomy: A Viable Alternative to Total Hip Replacement Surgery

A femoral osteotomy, which is the surgical cutting and repositioning of the femoral or hip bone, is a viable and effective surgical option for those afflicted with chronic hip disease, which includes osteoarthritic disorders, hip dysplasia, and other diseases of the hip that alter the hip’s bio-mechanics. Still routinely used as a surgical treatment throughout Europe, femoral osteotomies have become an infrequently used surgical method in the United States as total hip replacement surgery continues to evolve into the treatment of choice for those afflicted with a plethora of debilitating hip disorders. However, as effective and life-transforming as total hip joint replacement surgery can be, there are still good reasons to consider femoral osteotomy as a viable treatment option.

The main advantage that a femoral osteotomy has over a total joint replacement is the absence of any artificial parts. With a total hip replacement procedure, the diseased areas of the hip joint are replaced with artificial parts, most commonly metal and/or plastic, and these parts eventually wear out. Artificial parts are incapable of repairing and/or regenerating themselves, and through the normal wear and tear of everyday life, these artificial parts eventually wear out and fail. And this requires another operation – a revision operation – that replaces the worn artificial parts with new parts. These revision procedures are more difficult to perform and often times the end result is not as good as the initial replacement procedure. As beneficial as total hip joint replacement procedures are, they are not as beneficial for the young and/or highly active individual due to their limited shelf life. And this is where the femoral osteotomy procedure has a clear advantage.

A femoral osteotomy is a straight forward procedure that is designed to alter the shape of the hip joint itself; it’s goal is to shift healthier areas of bone into the main weight-bearing area within the hip joint. There are various types of femoral osteotomy procedures available, and the type and extent of the osteotomy procedure will be determined by the individuals type of hip problem. However, the overall procedure and goal of any femoral osteotomy is the same. After the surgeon makes the appropriate cuts to the affected areas of the hip joint and reorients the positions of the bones, the repaired bone is held together with pins and/or plates during the time it takes for the bones to heal. After a period of months, as the bone fully heals into its new position, the metal hardware is removed. The end result is a better functioning hip joint devoid of any artificial or foreign parts. You are left with your own hip joint; no plastic or metal parts that will eventually need to be replaced. With a successful procedure and outcome, a femoral osteotomy may eliminate the need for any further surgical intervention.

As with any surgical procedure, there are risks involved. A femoral osteotomy procedure is major surgery that requires the skills of a dedicated and experienced surgeon. As this type of surgery is not as common as it once was, it pays to do an extensive search to ensure that you find the right surgeon. Although many femoral osteotomies have excellent outcomes, there are certain complications that are endemic to this procedure. The main complication that can occur with this procedure is the development of avascular necrosis(AVN). This serious complication occurs when the blood supply nourishing the bone is disrupted. If this disruption is severe enough, the bone starts to die and degenerate. This can lead to immense pain and disability, and this will normally require a total joint replacement procedure to correct. In addition to the chance of infection, there is a small chance that the osteotomy incision will not heal properly or that the altered position of the hip joint itself will not be optimal. So, as with any operation, the skill and experience of the surgeon is of paramount importance, and every step necessary should be taken to find the most qualified surgeon to perform this surgery.