Prevalence of combined abnormalities of tibial and femoral torsion in patients with symptomatic hip dysplasia and femoroacetabular impingement.

Lerch, Till D.; Liechti, Emanuel F.; Todorski, Inga A. S.; Schmaranzer, Florian; Steppacher, Simon D.; Siebenrock, Klaus A.; Tannast, Moritz; Klenke, Frank M. (2020). Prevalence of combined abnormalities of tibial and femoral torsion in patients with symptomatic hip dysplasia and femoroacetabular impingement. The Bone & Joint Journal, 102-B(12), pp. 1636-1645. British Editorial Society of Bone and Joint Surgery 10.1302/0301-620X.102B12.BJJ-2020-0460.R1

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AIMS

The prevalence of combined abnormalities of femoral torsion (FT) and tibial torsion (TT) is unknown in patients with femoroacetabular impingement (FAI) and hip dysplasia. This study aimed to determine the prevalence of combined abnormalities of FT and TT, and which subgroups are associated with combined abnormalities of FT and TT.

METHODS

We retrospectively evaluated symptomatic patients with FAI or hip dysplasia with CT scans performed between September 2011 and September 2016. A total of 261 hips (174 patients) had a measurement of FT and TT. Their mean age was 31 years (SD 9), and 63% were female (165 hips). Patients were compared to an asymptomatic control group (48 hips, 27 patients) who had CT scans including femur and tibia available for analysis, which had been acquired for nonorthopaedic reasons. Comparisons were conducted using analysis of variance with Bonferroni correction.

RESULTS

In the overall study group, abnormal FT was present in 62% (163 hips). Abnormal TT was present in 42% (109 hips). Normal FT combined with normal TT was present in 21% (55 hips). The most frequent abnormal combination was increased FT combined with normal TT of 32% (84 hips). In the hip dysplasia group, 21% (11 hips) had increased FT combined with increased TT. The prevalence of abnormal FT varied significantly among the subgroups (p < 0.001). We found a significantly higher mean FT for hip dysplasia (31°; SD 15)° and valgus hips (42° (SD 12°)) compared with the control group (22° (SD 8°)). We found a significantly higher mean TT for hips with cam-type-FAI (34° (SD 6°)) and hip dysplasia (35° (SD 9°)) compared with the control group (28° (SD 8°)) (p < 0.001).

CONCLUSION

Patients with FAI had a high prevalence of combined abnormalities of FT and TT. For hip dysplasia, we found a significantly higher mean FT and TT, while 21% of patients (11 hips) had combined increased TT and increased FT (combined torsional malalignment). This is important when planning hip preserving surgery such as periacetabular osteomy and femoral derotation osteotomy. Cite this article: Bone Joint J 2020;102-B(12):1636-1645.

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 Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology

UniBE Contributor:

Lerch, Till; Liechti, Emanuel; Todorski, Inga Almut Senta; Schmaranzer, Florian; Steppacher, Simon Damian; Siebenrock, Klaus-Arno; Tannast, Moritz and Klenke, Frank M.

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2049-4394

Publisher:

British Editorial Society of Bone and Joint Surgery

Language:

English

Submitter:

Kathrin Aeschlimann

Date Deposited:

04 Dec 2020 14:06

Last Modified:

04 Dec 2020 14:10

Publisher DOI:

10.1302/0301-620X.102B12.BJJ-2020-0460.R1

PubMed ID:

33249913

Uncontrolled Keywords:

Developmental dysplasia of the hip Femoral anteversion Femoral derotation osteotomy Femoral torsion Femoroacetabular impingement Hip arthroscopy Hip dysplasia Tibial torsion Torsional deformity

BORIS DOI:

10.7892/boris.149056

URI:

https://boris.unibe.ch/id/eprint/149056

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