Does Femoral Retroversion Adversely Affect Outcomes After Hip Arthroscopy for Femoroacetabular Impingement Syndrome? A Midterm Analysis
Authors: Lall AC, Battaglia MR, Maldonado DR, Perets I, Laseter JR, Go CC, Domb BG
DOI: 10.1016/j.arthro.2019.03.046
Background
Femoral retroversion (reduced or negative femoral anteversion) has been theorized to impact outcomes following hip arthroscopy for femoroacetabular impingement syndrome (FAIS). Its clinical relevance, however, is not fully established.
Methods
- A cohort of 59 patients with femoral retroversion (≤5°) who underwent hip arthroscopy for FAIS was followed for 5 years and compared to a matched cohort with normal femoral version.
- Patient-reported outcome measures, including mHHS, NAHS, iHOT-12, and pain scores, were analyzed.
Key Findings
- Both groups showed significant improvements in pain and function, with no statistically significant differences between retroverted and normal version groups.
- Femoral retroversion did not appear to compromise outcomes over midterm follow-up.
Conclusions
Femoral retroversion should not be considered a contraindication to hip arthroscopy for FAIS, but it remains an important preoperative planning variable.
What Does This Mean for Providers?
- Femoral version assessment should remain standard in preoperative imaging and surgical planning, but the presence of retroversion alone does not predict inferior outcomes.
- Arthroscopy can still yield clinically meaningful improvements, even in anatomically retroverted femurs, if surgical technique and patient selection are optimized.
- Providers should continue to monitor longer-term data and consider combining imaging with functional and biomechanical evaluations in complex or borderline cases.