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Author Topic: Femoral Anteversion - femoral derotation osteotomy  (Read 855 times)

Offline jcbauman

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Femoral Anteversion - femoral derotation osteotomy
« on: July 22, 2013, 05:03:37 PM »
My 10 year old daughter is scheduled for a femoral derotation osteotomy due to femoral anteversion.  She has been watched since age 4.  The Dr. at Childrens in Boston believed she would outgrow it, as 99% of patients due by the time they are 9 or 10.  She will be 11 in October.  She started getting pain in both her kegs last September.  She had pain before that but it was not as constant.  Last September she started taking multiple dance classes, basketball then lacrosse in the Spring.  Her pain started on her bottom legs, gradually going up and now it is all of her legs and sometimes her hips.  Since this is a major surgery and major recovery we asked what else cold be causing pain.  We saw a genetic Dr. to rule out Elos Danlos (she does have the hypermobility type which is pretty much a beneign disease) She has seen a cardiologist which ruled out connective tissue disorder and she just recently has a bone scan in case there were any small hairline fractures.  The Dr. said he has done this surgery on kids that have pain but it is unusual.  Aside from the pain level, my daughter would like this done for cosmetic reasons.  She walks with her feet turned in and sometimes trips over them.  Her degree of turning is 50 degrees in one hip and 49 in the other.  I don't know if we would be having this done if she did not have pain.  The surgery is 5 hours long.  They do both femors at once.  Basically they will make small incisions at the left and right of her hip, cut through some muscle to get to the bone and then rotate cut both femurs in half, rotate them to be more straight then put them back.  She will be in the hospital for 6 days, a wheelchair for 4 weeks then a walker.  Has anyone had this surgery or had a child that had the surgery?  She will have an epidural for 2 days then pain medicine in the hospital as well as medicine at home.  I wonder how her pain will be the first few weeks at home.  If anyone has any information it would be much appreciated.

Thank you!

Offline allyd

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Re: Femoral Anteversion - femoral derotation osteotomy
« Reply #1 on: July 22, 2013, 05:29:33 PM »
There are many on the board that have had this done, as well as many parents asking the same questions/concerns that you’ve outlined. If you do a key word ‘search’ of the post-op boards, you may find some stories that will help you. I also suspect some people will be able to give you a little more direct feedback to your questions. While I don’t have the same problems – the stories I’ve read seem to indicate you are making the right decisions. You are correct in that It is not a common problem/surgery. Many on the board have waited until adulthood to find answers to their pain and ultimately have theirs fixed. Surgeons are seemingly more hesitant to do this operation on adults. Being young, your daughter will likely heal quickly and successfully, and avoid all the pain and problems down the road. Short term stress for a long term gain.

Seems like you’ve done your homework and exhausted the options before making the decision. Know and trust that you are heading in the right direction.
04/09 RK - Dislocated Patella & Grade III MCL Tear
06/10 RK - Re-Dislocation Patella
09/11 RK - MPFLr + Lateral Lengthening

Offline crankerchick

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    • Derotation osteotomy & TTT Post-op diary
Re: Femoral Anteversion - femoral derotation osteotomy
« Reply #2 on: July 22, 2013, 05:39:57 PM »
Post by rschinz are the most recent I can remember for a younger person having this done, and on both legs at once. Definitely search on here in patellofemoral and post-op diary section for derotational/derotation osteotomy and femoral anteversion, as allyd suggested, and you will see some hits.

I had this surgery on my left femur and tibia as an adult. I just did one leg and will do my other one if/when it really makes my life terrible. The pain isn't so bad in it now and there is little instability so I'm not touching it for now. My now straight leg is dare I saw perfect.

My ortho talks about this condition and always goes on about how it becomes an adult problem because it's not corrected as a child once it's evident they haven't grown out of it. I saw many doctors for my pain and instability as a child and none of them ever knew problem. I didn't in-toe nor did my knees turn in noticeably (likely due to the tibia having external rotation to offset) so no one ever even considered rotational malalignments on me. It wasn't until I was an adult and couldn't take it anymore and was finally able to find the guys who knew what to look for and test for.

I most certainly don't regret my decision to fix my knees. It's a rough surgery, even on just one limb, but for me it was well worth it. I could barely walk on my left leg by the time of my surgery because the patella was so unstable and subluxing constantly.

Everyone of course doesn't end up that way. I went a long time as an adult cutting back on activity and going mostly fine. My pain did decrease a lot as an adult, but the instability is what remained and deteriorated.

It's a hard sell on whether to do surgery now or later, but I would think in the presence of pain, waiting just doesn't seem worth the risk. I doubt my mom would have waited if surgery had been offered to us. When I think back to the pain I had as a child, I don't think I would have wanted to wait either.
« Last Edit: July 22, 2013, 05:41:59 PM by crankerchick »
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline jcbauman

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Re: Femoral Anteversion - femoral derotation osteotomy
« Reply #3 on: July 22, 2013, 06:13:35 PM »
Thank you both Ally and Crankerchick for replying.  I am trying to search on the username rschinz but I don't think I am doing it right?

Offline crankerchick

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Re: Femoral Anteversion - femoral derotation osteotomy
« Reply #4 on: July 22, 2013, 06:30:44 PM »
Finally got the site to load at work. Was typing from phone before. Looks like I got the user name wrong.

Here's the post-op diary for schinz (no r, whoops):
http://www.kneeguru.co.uk/KNEEtalk/index.php?topic=59790.msg585291#msg585291

Also, yeah the top "search site" box is where you want to type your other inquiries. I think if you search on anteversion or derotation/derotational osteotomy you will get quite a few hits.
Mar '07 - plica excision
Oct '09 - femoral + tibial derotational osteotomy & TTT
Aug '10 - hardware removal
"You control your leg. Don't let it control you." -Smart trainer
"Get your a$$ in gear and go for it! Nothing will happen until you make it!" -Smart doctor

Offline Lyndsey

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Re: Femoral Anteversion - femoral derotation osteotomy
« Reply #5 on: July 24, 2013, 04:31:58 AM »
I too have had my femurs derotated. I didn't do both legs at once, I did the right and then about 6 months later did the left. I started with the surgeries when I was 18 or 19... I have had pain in my knees and hips all my life, and had always complained. The doctor always told me it was just growing pains and it would go away. Well, it never did and so I had the surgery to derotate my femurs. Part of me wishes I would have had it done when I was younger, then maybe I would have less pain now... years of being twisted couldn't have been good. I don't regret having the surgery, my legs are much more stable now. I don't worry about tripping or falling. I can run if I have too, whereas before I couldn't. The recovery was long, but not terrible... I had an epidural and after that the pain was manageable with meds. I can't imagine having both legs done at once, but I  they do that with the younger patients sometimes. Although, my first surgery went really well, so I wasn't hesitant to do the left leg. Of course the left couldn't be as easy, no it still causes me pain sometimes.

Hope all goes well for you guys!
Lyndsey
"Miserable Malalignment"

5/15/08      right femoral derotational osteotomy
1/19/09      left femoral derotational osteotomy
12/17/09    hardware removal (L&R femoral blade plates and screws)
10/28/10    removal of bone chip and cleanup of scar tissue on left

 















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