Femoroplasty: Definition, Uses, and Clinical Overview

Femoroplasty Introduction (What it is)

Femoroplasty is a surgical reshaping of the femur near the hip joint.
It most commonly targets the femoral head–neck junction to improve hip clearance during motion.
Femoroplasty is often performed during hip arthroscopy for femoroacetabular impingement (FAI).
It may be combined with treatment of the labrum or cartilage when those tissues are affected.

Why Femoroplasty used (Purpose / benefits)

Femoroplasty is used to address abnormal contact between the ball of the hip (the femoral head) and the socket side of the joint (the acetabulum). In many patients with hip impingement, the femoral head–neck junction is not smoothly contoured. During hip flexion and rotation (such as sitting low, squatting, pivoting, or sport-specific cutting), this mismatch can cause the femur to abut the rim of the socket earlier than intended.

At a high level, the purpose of Femoroplasty is to:

• Reduce mechanical impingement by improving the “head–neck offset” (the contour and clearance between the femoral head and femoral neck).
• Improve hip motion tolerance by decreasing early bony conflict during flexion and rotation.
• Support joint preservation goals in selected cases by addressing a structural contributor to labral or cartilage overload.
• Complement soft-tissue repairs (for example, labral repair) by reducing the chance that repaired tissue is repeatedly pinched during everyday movement.

Benefits are typically framed in functional terms—such as less impingement-type pain and improved ability to move through certain ranges—rather than as a guarantee of preventing arthritis or eliminating symptoms. Outcomes depend strongly on the overall hip condition, including cartilage health and any coexisting anatomy.

Indications (When orthopedic clinicians use it)

Common scenarios where clinicians may consider Femoroplasty include:

• Symptomatic cam-type femoroacetabular impingement (cam FAI), where extra bone on the femoral head–neck junction contributes to impingement mechanics
• Hip pain and/or mechanical symptoms (for example, catching) with clinical findings consistent with FAI, when imaging supports a cam morphology
• Hip arthroscopy performed for a labral tear where a cam lesion is believed to be a key driver of ongoing impingement
• Persistent activity-related groin pain suspected to be due to impingement after nonoperative measures have been tried (timing and selection vary by clinician and case)
• Revision hip arthroscopy when residual or recurrent cam morphology is suspected to contribute to symptoms (case selection varies)

Contraindications / when it’s NOT ideal

Femoroplasty may be less suitable, or require a different approach, in situations such as:

• Advanced hip osteoarthritis (significant joint-space narrowing and diffuse cartilage wear), where reshaping alone is less likely to address pain drivers
• Hip dysplasia (under-coverage of the femoral head by the acetabulum), where bony reshaping of the femur may not correct the primary stability problem and other procedures may be considered
• Hip instability patterns (including certain forms of microinstability), where reducing bone without addressing stability factors may be inappropriate
• Active infection or systemic illness that makes elective surgery higher risk
• Poor surgical candidacy due to medical comorbidities or anesthesia risk (specific thresholds vary by clinician and facility)
• Unclear pain source, where symptoms are more consistent with lumbar spine, abdominal/pelvic, or non-hip conditions and the structural findings are incidental
• Severe deformity or complex anatomy where an open approach or different reconstructive plan may be more appropriate (varies by clinician and case)

How it works (Mechanism / physiology)

Biomechanical principle

The hip is a ball-and-socket joint designed to allow smooth motion with stable coverage. In cam-type impingement, the femoral head is less spherical at the head–neck junction. When the hip flexes and rotates, this “bump” can contact the acetabular rim earlier, increasing shear forces at the labrum and adjacent cartilage.

Femoroplasty works by recontouring the femoral head–neck junction to restore a more favorable shape and clearance. The goal is to allow the femoral head to rotate in the socket with less abnormal contact at positions that previously provoked impingement.

Relevant anatomy and tissues

Key structures commonly referenced in the clinical discussion include:

• Femoral head: the “ball” of the joint
• Femoral neck: the narrowed region below the head; the head–neck junction is where cam morphology is often located
• Acetabulum: the socket portion of the pelvis
• Labrum: a fibrocartilaginous rim that helps seal and stabilize the joint
• Articular cartilage: the smooth surface lining both joint sides; damage here can influence symptoms and prognosis
• Capsule: the soft-tissue envelope of the joint, relevant for stability and postoperative stiffness/instability considerations

Onset, duration, and reversibility

Femoroplasty is a structural, permanent change to bone. Its intended biomechanical effect is immediate once the contour is reshaped, but symptom improvement (when it occurs) depends on multiple factors, including postoperative inflammation, rehabilitation, and the condition of the labrum and cartilage. Reversibility does not apply in the way it would for medication; however, if inadequate reshaping or over-resection occurs, subsequent management may be complex and individualized (varies by clinician and case).

Femoroplasty Procedure overview (How it’s applied)

Femoroplasty is generally discussed as a surgical procedure, most often performed arthroscopically (through small portals using a camera and specialized instruments). A high-level workflow typically includes:

1. Evaluation / exam – History and physical exam focused on hip motion, impingement-type pain patterns, and functional limitations
   – Imaging review, often including X-rays and, when indicated, MRI or MR arthrography to assess labrum and cartilage (choice varies by clinician and case)

2. Preparation – Preoperative planning that considers the location and extent of cam morphology
   – Surgical setup and positioning to access the hip joint safely (techniques vary)

3. Intervention – Arthroscopic assessment of the joint structures (labrum, cartilage, capsule)
   – Bone reshaping at the femoral head–neck junction using specialized instruments
   – When needed, additional procedures may be performed in the same setting (for example, labral repair, acetabuloplasty, or capsular management), depending on findings and surgeon preference

4. Immediate checks – Intraoperative assessment of hip motion and clearance after reshaping
   – Review of stability considerations and completion of any planned soft-tissue work

5. Follow-up – Postoperative visits to monitor healing and function
   – Rehabilitation progression, commonly guided by physical therapy and surgeon protocol (details vary widely)

This overview intentionally avoids step-by-step surgical technique details, since exact methods depend on anatomy, pathology, and surgeon training.

Types / variations

Femoroplasty is not a single uniform technique; it can vary based on approach, goals, and what else is treated during the same operation. Common variations include:

• Arthroscopic Femoroplasty
• The most common contemporary approach for cam FAI in many centers

• Often combined with arthroscopic management of labral pathology and cartilage findings

• Open or mini-open femoroplasty

• May be considered for complex deformity, revision settings, or when combined approaches are preferred (varies by clinician and case)

• Isolated Femoroplasty

• Focused primarily on femoral reshaping when acetabular over-coverage is not a major driver and soft-tissue pathology is limited

• Combined femoral and acetabular procedures

• Femoroplasty + acetabuloplasty when both cam morphology (femur-side) and pincer morphology (socket-side over-coverage) contribute

• Combined procedures may also include labral repair/reconstruction, chondroplasty (cartilage smoothing), or capsular closure/plication depending on findings

• Primary vs revision

• Primary: first-time correction of cam morphology
• Revision: performed after prior surgery when residual deformity, scar, or other factors are suspected contributors (decision-making is highly individualized)

Pros and cons

Pros:

• Can directly address cam-type bony morphology contributing to femoroacetabular impingement
• Often performed through minimally invasive arthroscopy, which may reduce soft-tissue disruption compared with larger open exposures (experience varies)
• May be combined with labral and cartilage procedures during the same operation when appropriate
• Aims to improve biomechanics and motion clearance, which can be relevant for sport and work activities
• Provides an opportunity for direct joint assessment of labrum and cartilage during surgery

Cons:

• It is surgery, with inherent anesthesia and procedural risks
• Symptom improvement can be variable, especially when cartilage damage or arthritis is present
• Bone reshaping is not reversible, and under- or over-correction may affect outcomes (varies by clinician and case)
• Recovery often requires rehabilitation and activity modification during healing
• Some patients experience persistent pain or stiffness, depending on preoperative factors and postoperative course
• May not address pain when the primary source is non-hip (spine, tendon, pelvic, or other causes)

Aftercare & longevity

Aftercare following Femoroplasty typically focuses on protecting healing tissues, restoring motion, rebuilding strength, and gradually returning to daily activities and sport-specific demands. Protocols vary by surgeon, the extent of bony work, and any additional procedures performed (such as labral repair or capsular tightening).

Factors that commonly influence outcomes and durability include:

• Cartilage status at the time of surgery

• More extensive cartilage wear can limit symptom improvement and long-term joint preservation potential.

• Labral condition and treatment

• Repair, reconstruction, or debridement choices (when relevant) may affect stability and symptom patterns.

• Rehabilitation quality and consistency

• Range-of-motion work, gait normalization, and progressive strengthening are often emphasized, but specifics differ by protocol.

• Weight-bearing status and movement restrictions

• Temporary restrictions are common in many protocols, especially when combined procedures are performed. Exact timing and limits vary by clinician and case.

• Return-to-activity demands

• High rotational loads, deep flexion, and impact activities can stress the hip differently than routine walking or desk work.

• Patient-specific anatomy and comorbidities

• Conditions affecting bone quality, tissue healing, pain sensitivity, and baseline conditioning can alter recovery trajectory.

“Longevity” in this context usually refers to how long symptom relief and function are maintained. Because hip impingement is influenced by anatomy, activity, and cartilage health, durability varies by clinician and case, and it is typically discussed alongside the degree of pre-existing joint degeneration.

Alternatives / comparisons

Management of hip pain related to suspected impingement commonly includes a spectrum of options. Comparisons are best understood as differences in goals, invasiveness, and the type of problem each option targets.

• Observation / monitoring

• Appropriate in some cases when symptoms are mild, intermittent, or improving, or when imaging findings are present but not clearly linked to symptoms.

• Activity modification and physical therapy

• Often used to improve hip and core strength, movement patterns, and symptom control. These approaches do not change bone shape but may reduce symptom-provoking mechanics.

• Medications

• Nonoperative symptom management may include anti-inflammatory medications or other pain-modulating strategies. These can reduce pain and inflammation but do not address structural impingement morphology.

• Injections

• Image-guided intra-articular injections may be used diagnostically (to help confirm the joint as a pain source) and/or therapeutically for temporary symptom relief. Duration and effectiveness vary.

• Acetabuloplasty (socket-side reshaping)

• Considered when pincer morphology (acetabular over-coverage) is a major contributor. It addresses the socket rim rather than the femoral head–neck junction.

• Periacetabular osteotomy (PAO)

• A reconstructive pelvic procedure more commonly associated with dysplasia and under-coverage, aiming to improve acetabular orientation and joint mechanics. It targets stability and coverage rather than cam morphology.

• Hip arthroplasty (partial or total hip replacement)

• Considered in cases with significant arthritis where joint preservation procedures are less likely to provide meaningful benefit.

These options are not mutually exclusive; clinicians often consider them in sequence or combination based on symptoms, exam findings, imaging, and patient goals.

Femoroplasty Common questions (FAQ)

Q: Is Femoroplasty the same as hip arthroscopy?
Femoroplasty is a specific procedure that may be performed during hip arthroscopy. Hip arthroscopy refers to the overall minimally invasive surgical approach to the hip joint. A single arthroscopy may include femoroplasty plus other steps such as labral repair or acetabuloplasty.

Q: What problem does Femoroplasty treat?
It is most commonly used to address cam-type femoroacetabular impingement, where extra bone at the femoral head–neck junction contributes to abnormal contact with the acetabulum. The intent is to improve clearance during hip motion. Whether this translates into symptom relief depends on many factors, including cartilage and labral health.

Q: How painful is recovery after Femoroplasty?
Pain experiences vary widely and are influenced by the extent of surgery and individual factors. Early postoperative discomfort is common after arthroscopic hip procedures. Clinicians typically use multimodal pain control strategies, but specifics vary by clinician and case.

Q: How long does it take to recover?
Recovery is usually discussed in phases and often measured in weeks to months rather than days. The timeline can differ based on whether femoroplasty was combined with labral repair, capsular procedures, or cartilage work. Return to sport or heavy labor is typically later in the process and varies by clinician and case.

Q: Will I be able to walk right away?
Many protocols allow some form of walking soon after surgery, often with assistive devices. Weight-bearing limits—if any—depend on what was done during the procedure and surgeon preference. This is commonly individualized.

Q: When can someone drive after Femoroplasty?
Driving depends on multiple factors, including which side was operated on, comfort, strength and reaction time, and use of pain medications that can impair driving. Clinicians and facilities often provide criteria-based guidance rather than a single fixed date. Timing varies by clinician and case.

Q: How long do the results last?
Because femoroplasty changes bone shape, the structural change is permanent. Symptom relief and functional durability depend on the condition of the labrum and cartilage, activity demands, and whether arthritis is present. Long-term outcomes vary by clinician and case.

Q: Is Femoroplasty considered safe?
It is a commonly performed orthopedic procedure in appropriately selected patients, but it still carries risks, including infection, blood clots, nerve irritation, stiffness, persistent pain, or the need for additional surgery. Risk level is influenced by patient health, anatomy, and the details of the procedure. Discussions of risk are typically individualized.

Q: What does Femoroplasty cost?
Cost varies widely based on country, facility, insurance coverage, surgeon fees, imaging, anesthesia, and whether additional procedures (like labral repair) are performed. Because billing codes and bundled services differ, a single universal price range is not reliable. Many patients obtain the most accurate estimate through their surgical facility and insurer.