Coxa valga is a type of hip deformity where the angle at the point 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 neck of the femur. Both conditions can be diagnosed by an orthopedic doctor by evaluating the patient and looking at medical imaging studies, such as X-rays.
When children are born, this angle is naturally broad, often greater than 150 degrees. As people mature and the musculoskeletal system develops, the angle tightens, and tends to settle between 120 and 130 degrees. In people with coxa valga, the wide angle associated with childhood is retained into adolescence and adulthood. This can cause discomfort and instability in the hips, in addition to making it hard for patients to bear weight. Older adults with this condition are also at increased risk of developing osteoarthritis.
This deformity is associated with muscle weakness around the hips, as seen in neuromuscular conditions like cerebral palsy. People with these conditions may receive regular evaluations throughout childhood to check for the early warning signs of conditions like coxa valga so they can be addressed. Physical therapy is also used to develop muscular strength with the goal of promoting healthy skeletal development.
Diagnosis of this condition requires taking an X-ray with the hip at a neutral angle so a doctor can measure the angle at the neck of the femur. It is important for the patient to hold the right position, as if the hip splays out or twists, it can change the appearance of the angle and may lead to a misdiagnosis. The patient will also be evaluated to see if issues like chronic pain in the hip or difficulty walking have developed. In a patient with no complications, the coxa valga deformity may be left, as it is without any medical intervention.
Treatment for extreme cases of coxa valga is a varus osteotomy, also called a femoral osteotomy, where an orthopedic surgeon cuts the bone and repositions it. This surgery carries risks like adverse reactions to anesthesia and infection and it is very invasive. As a result, it is only recommended when a patient is clearly in need of surgical intervention. Surgical outcomes can be improved by working with a surgeon who has substantial experience with hip deformities and surgery on the hips.
