Most of patients with femoral derotation osteotomy for posterior extraarticular hip impingement and high femoral version would do surgery again.

Lerch, Till; Schmaranzer, Florian; Steppacher, Simon D.; Ziebarth, Kai; Tannast, Moritz; Siebenrock, Klaus A. (2020). Most of patients with femoral derotation osteotomy for posterior extraarticular hip impingement and high femoral version would do surgery again. (In Press). Hip International, p. 1120700020953100. SAGE Publications 10.1177/1120700020953100

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AIMS

To assess (1) hip pain and function and ROM; (2) subsequent surgeries, complications; and (3) subjective satisfaction and PROMs in patients undergoing femoral derotation osteotomies.

METHODS

Femoral derotation subtrochanteric osteotomies to treat symptomatic posterior extraarticular ischiofemoral hip impingement were performed in 23 patients (25 hips) between 2013 and 2017. The mean age was 26 ± 8 years (96% female) with a minimum 2-year follow-up (mean follow-up of 4 ± 1 years). Surgical indication was a positive posterior impingement test and limited external rotation (mean 16° ± 8°) in extension in patients with abnormal high femoral version (mean 46° ± 9, measured on CT scans with the Murphy method) and high McKibbin instability index (mean 67°). Femoral osteotomies were combined with a surgical hip dislocation in 96% for cam resection and labrum or cartilage treatment. Preoperative MRI and 3D-CT with dynamic impingement simulation were evaluated.

RESULTS

(1) The posterior impingement test decreased significantly from preoperatively 100% to 4% (p < 0.001). External rotation in extension increased significantly (p < 0.001) from preoperative 16° ± 8 to 44° ± 16°. The MdA score increased significantly from 14 ± 1 to 16 ± 2 (p < 0.001) points.(2) At follow-up, all 25 hips were preserved. No conversion to THA and no revision osteosynthesis was performed. 64% underwent complete hardware removal.(3) 80% of the patients reported at follow-up that they would undergo surgery again. Subjective satisfaction (SHV) increased significantly (p < 0.001) from preoperatively 24% to 84% postoperatively.

CONCLUSIONS

Femoral derotation subtrochanteric osteotomies for the treatment of posterior extraarticular ischiofemoral hip impingement are safe and improve posterior hip pain and function and external rotation in mostly female patients with high femoral version and a high McKibbin instability index.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Surgery
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Lerch, Till; Schmaranzer, Florian; Steppacher, Simon Damian; Ziebarth, Kai; Tannast, Moritz and Siebenrock, Klaus-Arno

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1120-7000

Publisher:

SAGE Publications

Language:

English

Submitter:

Maria de Fatima Henriques Bernardo

Date Deposited:

03 Sep 2020 16:14

Last Modified:

04 Sep 2020 01:34

Publisher DOI:

10.1177/1120700020953100

PubMed ID:

32866044

Uncontrolled Keywords:

Extraarticular posterior hip impingement FAI femoral osteotomies; femoral torsion femoral version femoroacetabular impingement hip arthroscopy hip instability ischiofemoral hip impingement

BORIS DOI:

10.7892/boris.146295

URI:

https://boris.unibe.ch/id/eprint/146295

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