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Is there still any place for femoral osteotomy in conservative hip surgery?

Published in N°001 - May / June 2019
Article viewed 32 times

Is there still any place for femoral osteotomy in conservative hip surgery?

By Frédéric Laude, Alice Nlandu, Roxana Viamont-Guerra in category TECHNIQUE
Clinique du sport, 36 boulevard saint Marcel, 75005 Paris - France

In recent years there has been quite a marked revival in the popularity of hip salvage surgery. The concept of femoroacetabular impingement, as developed at length by Rheinold Ganz, has shed light on one of the major causes of osteoarthritis of the hip and made it possible to offer early treatment.

Introduction

In recent years there has been quite a marked revival in the popularity of hip salvage surgery. The concept of femoroacetabular impingement, as developed at length by Rheinold Ganz, has shed light on one of the major causes of osteoarthritis of the hip and made it possible to offer early treatment. Specifically, Ganz designed a technique involving an open approach with anterior surgical dislocation of the hip and trochanteric osteotomy,[1] which in turn has resulted in the proposal of a number of methods such as femoral head sphericalization and labral repair, with or without acetabuloplasty. Even though this surgery was initially developed as an open technique under the influence of its inventor, it is now routinely performed arthroscopically.

The concept of hip instability with or without acetabular dysplasia[3] has been around for several years, resulting in the proposal of certain original techniques that go beyond the ‘quasi-traditional’ periacetabular osteotomy, such as capsuloplasty.

A common procedure some fifty years ago, it is hardly ever taught to new surgeons nowadays despite being the best osteotomy for correcting proximal femoral deformities.

Instead, hip replacement surgery has taken over and relegated it into oblivion. A firm favourite among older...

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