Femoral Osteoplasty

What is Femoral Osteoplasty? 

Osteoplasty is a surgery performed to repair and redesign a bone to its original shape. The surgery is used to treat bone deformation in various joints of the body.

Femoral osteoplasty is the surgical alteration or reshaping of your femur (thigh bone). It is performed if you have an abnormally shaped femoral head or neck leading to a medical condition called femoroacetabular impingement (FAI), the most common cause of hip pain. 

Overview of FAI

Your hip is a ball and socket joint where the ball-like top of the thigh bone (femoral head) fits into a cup-like socket (acetabulum) in such a way that the ball can move smoothly within the socket.

Sometimes, an extra bone grows on the ball of the joint giving it an irregular shape. This bony growth (bone spur) on the ball is called a cam lesion. When this occurs, the ball is no longer a smooth spherical shape, resulting in the ball bumping into the socket when you bend, turn or move.

Young adults are at greater risk of FAI.

Significance of Femoral Osteoplasty

Over time, repetitive bumping or impingement of the ball on the socket leads to the damage and deterioration of the cartilage covering the ends of the bones in the joint. This causes painful rubbing and restricts the free movement of the ball within the socket.

The condition eventually leads to stiffness in the hip joint, and unbearable pain during regular activities and limping. 

Femoral osteoplasty can correct the irregularity of the ball shape, eliminate the pain, improve the range of motion and restore normal function to the hip joint.

The Procedure 

Initially, the doctor will recommend simple and non-operative measures such as rest, physical therapy, anti-inflammatory medications or certain types of injections to treat the condition. If they do not show adequate results, femoral osteoplasty is considered.

There are two types of osteoplasty.

• Arthroscopic osteoplasty: This is the minimally invasive option and usually the preferred approach.
• Open osteoplasty: This approach is a more invasive procedure and the least-preferred type. 

However, the type of osteoplasty depends on the severity and location of the abnormality.

During the arthroscopic osteoplasty:

• A small incision is made in the skin covering the affected hip joint.
• The arthroscope is then guided into the affected area in the joint.
• The hip is pulled apart slightly and the exact spot of the abnormality is identified.
• The excess bone spur is removed using a shaver or a radio thermal device.
• Any non-spherical portion of the femoral head (ball) is also removed. 
• Also, any unwanted tissue on or around the femoral head is also shaved off.
• The femoral head is reshaped and clearance in the joint is increased.
• The arthroscope and other surgical devices are withdrawn from the surgery site.
• The incision in the skin is closed with sutures and an appropriate dressing is applied.

If the condition is more severe or in an area that cannot be reached by arthroscopy, your doctor will opt for open osteoplasty.  

During open osteoplasty:

• An incision large enough to access the affected hip joint is made in the skin.
• The hip is dislocated, and the bone spurs are removed under direct visualization.  
• Any torn cartilage in the affected joint is removed using surgical instruments.
• The incision in the skin is sutured and an appropriate dressing is applied.

After the surgery, you will be advised to follow an individualized rehabilitation procedure until you fully recover.