Femoral Derotational Osteotomy

What Is Femoral Derotational Osteotomy?

Femoral derotational osteotomy is a surgical procedure used to correct abnormal rotation of the femur (thigh bone). Excessive inward or outward rotation of the femur can affect hip alignment, walking mechanics, and joint stability. This condition may contribute to hip pain, instability, or abnormal gait patterns. During the procedure, the surgeon carefully cuts the femur and rotates it into a more normal alignment before stabilizing the bone with surgical hardware such as plates and screws. Correcting the rotational alignment can help improve joint mechanics, relieve symptoms, and restore more natural movement.

When Is Femoral Derotational Osteotomy Recommended?

Femoral derotational osteotomy may be recommended when abnormal femoral rotation causes persistent symptoms or functional limitations. Your orthopedic surgeon may consider this procedure if you have:

• Excessive femoral anteversion or retroversion affecting hip alignment
• Hip pain or instability related to rotational deformity
• Abnormal gait or difficulty walking normally
• Hip impingement caused by rotational abnormalities
• Symptoms that do not improve with conservative treatment

What Does Preparation for Femoral Derotational Osteotomy Involve?

Preparation for femoral derotational osteotomy begins with a comprehensive evaluation of the hip and lower limb alignment. Your surgeon will review your medical history, perform a physical examination, and obtain imaging studies such as X-rays, CT scans, or MRI to assess bone structure and rotational alignment. Patients may be asked to stop certain medications before surgery and follow fasting instructions if anesthesia will be used. Your care team will also discuss postoperative expectations, including mobility restrictions, rehabilitation, and the use of assistive devices such as crutches.

How Is Femoral Derotational Osteotomy Performed?

During femoral derotational osteotomy, the surgeon makes an incision along the thigh to access the femur. A controlled surgical cut, called an osteotomy, is made in the bone. The femur is then carefully rotated to correct the abnormal alignment and restore proper orientation within the hip joint. Once the correct position is achieved, the bone is secured using plates, screws, or other fixation devices to maintain stability while the bone heals. Over time, the bone gradually heals in its corrected position.

What to Expect During Recovery After Femoral Derotational Osteotomy?

Recovery after femoral derotational osteotomy involves a gradual healing process. Patients typically use crutches or other assistive devices for several weeks to protect the bone while it heals. Physical therapy is an important part of recovery and focuses on restoring hip strength, flexibility, and normal walking patterns. Most patients gradually return to daily activities as healing progresses, although complete recovery and return to higher-impact activities may take several months.

What Are the Risks and Complications of Femoral Derotational Osteotomy?

As with any surgical procedure, there are potential risks and complications. These may include:

• Infection
• Bleeding
• Blood clots
• Nerve or blood vessel injury
• Delayed bone healing or nonunion
• Persistent pain or need for additional surgery

What Are the Benefits of Femoral Derotational Osteotomy?

When successful, femoral derotational osteotomy can provide several important benefits, including:

• Improved hip alignment and joint mechanics
• Reduction in hip pain and instability
• More natural walking and movement patterns
• Prevention or reduction of further joint damage
• Improved overall function and quality of life.