Rheumatology: Current Research
Open Access

Preoperative Assessment and Role of Femoral Osteotomy for Hip Impingement Syndromes

Ying Zhang^{* *}Correspondence: Ying Zhang, Department of Orthopedics, Shanghai University, Shanghai, China, Email:

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About the Study

Femoral osteotomy is a surgical procedure aimed at addressing hip impingement, a condition where abnormal contact between the femur and acetabulum leads to pain and restricted movement. In this procedure, a section of the femur is cut and realigned to improve joint mechanics and reduce impingement.

The surgery involves making an incision to access the hip joint, followed by cutting the femur bone to reposition it. This realignment corrects the abnormal contact points, reducing pain and improving the hip's range of motion. The procedure is often considered when conservative treatments, such as physical therapy and medication, are ineffective.

Recovery from femoral osteotomy typically involves a period of limited weight-bearing and physical therapy to strengthen the hip and restore function. The goal is to relieve symptoms, improve joint function and prevent further damage to the hip. The success of the surgery depends on factors such as the severity of the impingement and the patient’s adherence to post-operative care.

Hip impingement syndromes

It involves abnormal interactions between the femur and acetabulum, which can lead to hip pain and dysfunction. This abnormal interaction often results from anatomical variations in the shape of the hip joint. There are two primary types of impingement: Cam impingement, where the femoral head is not perfectly round and pincer impingement, where the acetabulum is excessively covering the femoral head. Both conditions can cause discomfort, restricted range of motion and over time, lead to degenerative changes in the hip joint.

Role of femoral osteotomy

Femoral osteotomy is utilized to address the underlying anatomical issues contributing to hip impingement. The procedure involves cutting and repositioning the femur to correct the abnormal alignment that causes impingement. By realigning the femur, the procedure aims to reduce or eliminate the abnormal contact between the femur and acetabulum, thereby alleviating symptoms and potentially preventing further joint damage.

Preoperative assessment and planning

Before undergoing femoral osteotomy, a comprehensive assessment is important. This typically involves a combination of clinical evaluation, imaging studies and patient history. The goal is to understand the specific anatomical abnormalities contributing to the impingement and to plan the optimal approach for correction.

Imaging studies, such as X-rays and Magnetic Resonance Imaging (MRI), are often employed to visualize the hip joint's structure and identify any deformities. These images help in planning the osteotomy procedure, including the precise location of the cut and the degree of realignment required.

Postoperative care and rehabilitation

After femoral osteotomy, the focus shifts to postoperative care and rehabilitation. The recovery process generally involves a period of immobilization and gradual mobilization of the hip joint. Rehabilitation is customized to individual needs, emphasizing regaining strength, flexibility and function.

Physical therapy plays a significant role in the rehabilitation process. Patients may engage in exercises designed to improve joint mobility, strengthen the surrounding muscles and restore functional movement. The overall aim is to ensure a successful recovery and optimal long-term outcomes.

Long-term management

Following femoral osteotomy involves regular follow-up visits to monitor the progress of healing and joint function. These visits may include clinical assessments and imaging studies to evaluate the alignment of the femur and the condition of the hip joint.

Principles behind femoral osteotomy

The primary goal of femoral osteotomy is to correct the mechanical abnormalities that lead to impingement. By repositioning the femoral head or neck, the procedure aims to restore normal joint mechanics and reduce pain and damage. The key principles of femoral osteotomy in the context of hip impingement include:

Realignment: Repositioning the femoral head or neck to achieve a more natural and functional alignment within the acetabulum.

Improved joint congruence: Improving the fit between the femoral head and acetabulum to reduce abnormal contact and stress on the joint.

Pain relief: Reducing the symptoms associated with impingement, such as pain and restricted motion, through improved joint mechanics.

General aspects of femoral osteotomy

Femoral osteotomy is a complex procedure that requires careful consideration of various aspects, including patient selection, preoperative planning and postoperative care.

Patient selection: Selecting appropriate candidates for femoral osteotomy involves evaluating factors such as the severity of impingement, the degree of anatomical abnormality and the overall health of the patient. It is important to assess whether the patient is likely to benefit from the realignment and if they have realistic expectations regarding the outcomes.

Preoperative planning: Detailed preoperative planning is need for the success of the procedure. This includes imaging studies such as X-rays or MRIs to assess the extent of the impingement and the specific anatomical abnormalities. Planning helps in determining the optimal alignment and positioning for the osteotomy.

Postoperative care: It is critical for the recovery and success of femoral osteotomy. This involves managing pain, monitoring for complications and implementing a rehabilitation program to restore hip function. Patients typically require a period of limited weight-bearing and physical therapy to regain strength and mobility.

Femoral osteotomy is a valuable surgical intervention for addressing hip impingement, a condition often rooted in structural abnormalities that hinder joint function and cause pain. By realigning the femur, the procedure corrects abnormal contact between the femur and acetabulum, thereby improving joint mechanics and potentially preventing further degenerative changes. This surgical approach is especially beneficial for patients who have not achieved relief through conservative methods like physical therapy and medication.