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Effect of femoral anteversion on clinical outcomes after hip arthroscopy.h Femoroacetabular Impingement.

Abstract:

Purpose: To compare the clinical outcomes after hip arthroscopy of patients with femoral retroversion, normal femoral version, and excessive femoral anteversion.

Methods: Patients who underwent primary hip arthroscopy from August 2008 to April 2011 and underwent femoral anteversion measurement by magnetic resonance imaging/magnetic resonance arthrogram were included. The patients were divided into 3 groups: retroversion, normal version, and excessive anteversion. The normal-version group was considered to have a value within 1 SD of the mean femoral version value. Four patient-reported outcome scores and the visual analog pain score were prospectively collected with analysis performed retrospectively.

Results: Two hundred seventy-eight patients met the inclusion criteria. Among these patients, mean anteversion was 8.2° ± 9.3°, creating a retroversion group defined as -2° or less and an anteversion group defined as 18° or greater. There were 25 patients in the retroversion group, 219 in the normal-version group, and 34 in the excessive-anteversion group. Most labral tears were noted in the 12- to 2-o'clock range, with the main difference at the anterior 3-o'clock position, where the excessive-anteversion group showed a lower incidence of tearing (30%) than the retroversion group (73%) and normal-anteversion group (78%). Postoperatively, there was a statistically significant improvement from preoperative scores in all 3 groups and for all scores (P < .001). When the postoperative scores were compared for the 3 groups, although all scores were higher in the retroversion group than in the other 2 groups, this was not statistically significant and there were no significant differences in scores among the 3 groups (modified Harris Hip Score, P = .104; Non-Arthritic Hip Score, P = .177; Hip Outcome Score-Activities of Daily Living, P = .152; Hip Outcome Score-Sport-Specific Subscale, P = .276; visual analog scale score, P = .508).

Conclusions: On the basis of patient-reported outcome scores without accounting for diagnoses and treatments, the amount of femoral anteversion does not appear to affect the clinical outcomes after hip arthroscopy.

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