Femoral derotational osteotomies are performed to correct symptomatic increased femoral torsion in adolescents and adults. The indications are anterior knee pain caused by patellar maltracking and patellofemoral instability.A lot of techniques have shown good clinical results with high patient satisfaction.There is no consensus as to which surgical techniques lead to the best outcomes in performing a femoral derotational osteotomy. Surgery often is performed according to the surgeon’s experience. Future studies should focus on radiographic and clinical assessment to understand different subtypes of torsional deformity and the level of the osteotomy on clinical outome.