Femoral osteotomy refers to a surgical procedure to correct specific femur (the long bone in the upper part of the leg) and hip joint deformities. In this procedure, the orthopedic surgeon cuts the bone and realigns it to restore normal anatomy. This addresses and prevents conditions related to the deformity.
These conditions may include labrum tears, articular cartilage damage in the hip joint, and various types of hip impingement (the abnormal rubbing between two bones that meet in the hip joint).
Femoral osteotomy can be a significant surgical procedure. But it is possible to perform it in a manner that is minimally invasive.
This allows the surgeon to leave the muscles and other vital structures around the hip unharmed. The surgery is less invasive if the neck-shaft angle is normal and the deformity is completely rotational (abnormal version).
The incision may be much smaller as the surgeon will not apply a plate to the femur. The incision will only need to be long enough to insert a rod into the femur from above.
The surgeon will use the same incision to cut the femur from within without exposing the osteotomy (bone cut) area. This technique does not require the muscles to be raised from the upper part of the femur.
Southern California Hip Institute (SCHI), led by board certified orthopedic surgeon Dr. Tigran Garabekyan, provides orthopedic surgery to patients in Los Angeles, Century City, CA, and surrounding locations.
Periacetabular Osteotomy (PAO)
Periacetabular osteotomy (PAO) is a surgical procedure that can help in native hip preservation in teenagers, young adults, and adults (typically up to 45 years of age) with dysplasia and other structural deformities of the hip.
The mechanical imperfections associated with structural hip deformity usually involve dysplasia and femoroacetabular impingement (FAI) and their related pathologies. In addition, hip pathology may involve malalignment or rotational femur deformities (such as problems with femoral torsion), among other aberrations.
Hip impingement happens when the proximal femur gets in contact with the acetabulum during a range of motions, such as internal rotation or flexion. This condition typically occurs due to over-coverage of the acetabulum (pincer type) or asphericity of the femoral head (cam type).
Symptomatic instability and early labral and cartilage degeneration may occur with dysplasia due to inappropriate femur head coverage by the acetabulum. This progression from impingement to instability is a vital factor in assessing younger patients experiencing hip pain.
Periacetabular osteotomy (PAO) treats the underlying structural abnormalities of a shallow or poorly oriented acetabulum. The PAO surgery involves multiple osteotomy cuts encompassing the acetabulum. This helps preserve the hip abductors and the posterior (the weight-bearing column of the pelvis).
The surgeon will then free the socket from the pelvis and reorient it in a positional of better femoral head coverage. This helps restore the normal hip joint mechanics as well as facilitate proper loading of the articular cartilage. The objective of this procedure is the long-term preservation of the natural joint in teens and young patients with dysplasia.
Patient selection is essential in PAO as it is not a “standard” surgery. It is a demanding procedure which requires osteotomy and precise reorientation. But the potential benefits of PAO including higher long-term joint stability and cartilage durability may help younger patients to delay or avoid a joint-replacement surgery such as a total hip arthroplasty.
Board certified orthopedic surgeon Dr. Tigran Garabekyan receives patients from Los Angeles, Century City, CA, and nearby areas for orthopedic surgery.
Dr. Tigran Garabekyan is a board certified orthopedic surgeon specializing in hip preservation. To learn more about Southern California Hip Institute or to schedule a consultation, click here to contact us or call:
Century City / Los Angeles: 310.595.1030
Serving patients in Encino, Sherman Oaks, Van Nuys, North Hollywood, Burbank, Glendale, West Hollywood, Century City, Beverly Hills, Santa Monica, Los Angeles, and other neighboring cities in the greater Los Angeles, California area.
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