Direct anterior approach for femoral osteotomy: a new surgical technique

Abstract Femoral osteotomy is an effective surgical intervention for correcting torsional deformities that contribute to hip instability and femoroacetabular impingement. However, traditional osteotomy techniques require extensive soft tissue dissection, disrupt the femoral canal, and complicate future total hip arthroplasty. Additionally, traditional approaches frequently involve multiple incisions when combined with other procedures, prolonging recovery and increasing morbidity. The direct anterior approach (DAA) offers a minimally invasive alternative that preserves the femoral anatomy while enabling simultaneous intra-articular interventions. This technique provides access to the femoral neck for varisation, valgisation, and rotational osteotomies while preserving critical vascular structures. Moreover, the DAA facilitates concurrent hip arthroscopy, periacetabular osteotomy, and cartilage restoration procedures. We describe the DAA for femoral neck osteotomy to correct torsional deformities and discuss its potential benefits in optimizing surgical outcomes.