EP1.92 Femoral osteotomy through hip arthroscopy: A new surgical technique

Abstract

Abstract Valgus deformities of the proximal femur reduce femoral head coverage, increase joint reaction forces, and overload the labrum and cartilage, contributing to early osteoarthritis. Corrective femoral osteotomy is a well-established treatment, but conventional open techniques are invasive, disrupt the femoral canal, and complicate potential future arthroplasty. This study describes a novel arthroscopic femoral neck varisation osteotomy using an extracapsular “first” approach designed to minimize surgical morbidity while preserving femoral anatomy and allowing simultaneous treatment of intra-articular pathology. Through two anterior portals, the hip was approached extracapsularly first under arthroscopic and fluoroscopic guidance. A triangular bone wedge was resected at the femoral neck using a burr, beginning 5 mm above the lesser trochanter and oriented toward the femoral shoulder. Osteotomy completion was achieved by controlled fracture with table-assisted traction. Fixation was performed with three cannulated screws. This minimally invasive technique preserves muscular and osseous structures, reduces surgical morbidity, and limits scarring. It also allows for simultaneous treatment of intra-articular pathology, such as femoroacetabular impingement, and preserves bone architecture, facilitating potential future total hip arthroplasty. Arthroscopic femoral neck osteotomy represents a feasible and less invasive alternative to traditional open techniques. It may expand hip preservation options in young patients with coxa valga while reducing morbidity and facilitating future reconstructive procedures.