Coxa valga is a hip deformity where the angle between the neck and shaft of the femur is wider than normal, causing discomfort and instability in the hips. It can be diagnosed through medical imaging and treated with physical therapy or surgery.
Coxa valga is a type of hip deformity in which the angle where the neck and shaft of the femur meet is greater than normal. Generally, angles greater than 140 degrees are a cause for concern in adult patients. A related condition, coxa vara, is characterized by an unusually small angle at the femoral neck. Both conditions can be diagnosed by an orthopedic doctor by evaluating the patient and looking at medical imaging studies, such as X-rays.
When babies are born, this angle is naturally large, often greater than 150 degrees. As people mature and the musculoskeletal system develops, the angle narrows and tends to stabilize at between 120 and 130 degrees. In people with coxa valga, the wide angle associated with childhood is maintained into adolescence and adulthood. This can cause discomfort and instability in the hips, as well as making it difficult for patients to bear weight. Older adults with this condition are also at a higher risk of developing osteoarthritis.
This deformity is associated with muscle weakness around the hips, as seen in neuromuscular conditions such as cerebral palsy. People with these conditions may receive regular assessments in childhood to check for early warning signs of conditions such as coxa valga so they can be addressed. Physical therapy is also used to build muscle strength with the goal of promoting healthy skeletal development.
Diagnosing this condition requires taking an X-ray with the hip at a neutral angle so that a doctor can measure the angle at the neck of the femur. It is important for the patient to maintain the correct position, as if the hip widens or twists, it can change the appearance of the angle and can lead to misdiagnosis. The patient will also be evaluated to see if any problems such as chronic hip pain or difficulty walking have developed. In an uncomplicated patient, the coxa valga deformity can be left as-is without any medical intervention.
Treatment for extreme cases of coxa valga is a varus osteotomy, also called a femoral osteotomy, in which an orthopedic surgeon cuts through the bone and repositions it. This surgery carries risks such as adverse reactions to anesthesia and infections, and is very invasive. Consequently, it is only recommended when a patient clearly needs surgery. Surgical outcomes can be improved by working with a surgeon who has considerable experience with hip deformities and hip surgery.
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