One-Stage Combined Hip Arthroscopy and Derotational Femoral Osteotomy on a Postless Traction Bed

Abnormal femoral torsion is associated with labral and chondral tears, hip pain, and early onset arthritis. Derotational femoral osteotomy (DFO) is the surgical treatment of choice to correct femoral torsional deformity, restore normal hip joint mechanics, and improve clinical outcomes. DFO is often performed in conjunction with hip arthroscopy to address intra-articular pathology, which requires hip joint distraction for visualization. In these cases, the same setup can be carried out seamlessly, allowing for an easy transition between procedures, thus increasing operative efficiency. Traditionally, this combined approach was performed using perineal post traction beds, which carry risks of groin complications and pudendal nerve injury, occasionally resulting in severe consequences. To avoid these complications, postless traction beds were developed to provide safe and reliable distraction without the morbidity associated with perineal posts. This technical note describes the operative management of dual hip arthroscopy and DFO with a postless traction bed offering a safe, reproducible, and efficient surgical technique for managing patients requiring concurrent hip arthroscopy and DFO. Additionally, this paper describes the advantages of the postless traction bed for DFO surgery, even if arthroscopy is not performed concurrently.