Femoral Osteotomy

A femoral osteotomy is a surgical procedure where the upper part of the thigh bone, or femur, is cut to position the ball into the socket in order to improve the weight bearing surface and allow more natural hip mechanics. This is commonly performed in combination with a pelvic osteotomy or hip arthroscopy.

Ganz Periacetabular Osteotomy (PAO)

The Ganz periacetabular osteotomy is used to treat patients who have hip dysplasia. The hip is a ball and socket joint. The “ball” of the hip is the femoral head (top of the thighbone) that sits in the “socket”, or acetabulum (part of the pelvis). In patients with hip dysplasia the ball is unstable in the socket. The Ganz procedure involves cutting around the socket so it can be moved into a position that provides better coverage of the ball.


Osteotomy Specialist

Jonathan Schiller, MD

Conditions that can be treated by a PAO or Derotational Osteotomy include:

DDH is a treatable condition that affects some babies and when untreated as a child will lead to significant problems later in life. The hip includes the ball of the thighbone (femur) and the socket where the ball fits. The socket is called the acetabulum. In babies born with DDH, the ball of the thighbone slips in and out of the socket. This repetitive instability gradually wears down the lining of the ball and socket, or cartilage, leading to arthritis.

Occurring most frequently in children, femoral anteversion is a condition where the femoral neck is angled forward and causes the patient’s feet and knees to rotate inward. Children with femoral anteversion often do not have pain and in most cases, the bone corrects as the child reaches skeletal maturity. In some cases, when the condition fails to correct, surgery is required to realign the bone.

This condition usually occurs during the teenage years when the thighbone is growing the most. Growth occurs at the growth plate in the upper neck portion of the thighbone, or femoral head. The upper neck portion of the thighbone slips from the growth plate, as seen on a hip x-ray. Children often limp or complain of thigh or knee pain. This may come on slowly or after an injury. The slip of the upper part of the head leads to chronic change in the bone and may lead to limping, long-term pain, and premature arthritis.