This protocol addresses juvenile osteochondrosis of the hip and pelvis in patients who have developed a hinge abduction phenomenon of the hip joint, with measured hip joint abduction reduced to less than 30 degrees. This degree of restricted motion defines a specific and surgically relevant sub-population.
When hinge abduction is present, the femoral head is no longer suitable for containment-restoring procedures. Surgical success depends on achieving sufficient abduction; with hip abduction below 30 degrees, the anatomical conditions require a different operative approach rather than standard containment surgery.
The current therapy of choice involves a proximal femoral osteotomy targeting the geometry of the femur. The procedure is designed to reposition the loading zone of the femoral head and improve biomechanical conditions at the hip. The full surgical goals, technique details, and post-operative protocol are outlined in the complete structured regimen →
DOI: 10.1007/s00402-025-05801-3
In this case, the femoral head is no longer suitable for containment-restoring procedures such as FVO, SIO or TPO.
However, regarding surgical treatment an abduction of the affected hip joint of at least 30 degrees is required to ensure surgical success.
Today, the therapy of choice is a femur valgus extension osteotomy (FVEO).
FVEO is a procedure to address coxa vara or hinge abduction phenomena in LCPD.
The aim of this procedure is to integrate the medial, better-preserved part of the femoral head into the loading zone, reduce adduction contracture, distalize the greater trochanter, which can functionally lengthen the femoral neck and improve biomechanical conditions of the abductor muscles.
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