Femoral Derotation Osteotomy in Adults for Version Abnormalities

Area of Science:

• Orthopedic Surgery
• Biomechanical Engineering

Background:

• Femoral version abnormalities, such as excessive anteversion or retroversion, can lead to hip pain, impingement, and joint damage.
• These conditions necessitate surgical intervention to restore normal hip biomechanics and alleviate symptoms.

Purpose of the Study:

• To evaluate the safety and efficacy of closed, subtrochanteric derotation osteotomy for correcting femoral anteversion and retroversion.
• To assess clinical outcomes and complication rates associated with this surgical procedure.

Main Methods:

• A retrospective review of 55 subtrochanteric derotation osteotomies in 43 patients (36 female, 7 male; average age 29 years).
• Procedures were performed closed using an intramedullary saw and fixation with intramedullary nails.
• Patients presented with either excessive anteversion (71%) or retroversion (29%) of the femur, with various etiologies including idiopathic, posttraumatic, and genetic syndromes.

Main Results:

• At an average follow-up of 6.5 years, the modified Harris Hip Score improved significantly (by 29 points, P < 0.001).
• Overall success rate was high, with 93% of cases rated as excellent or good.
• Complications included 5% failure rate (two hip arthroplasties, one nonunion) and one late infection; 78% of hips required subsequent surgery, primarily for implant removal.

Conclusions:

• Closed subtrochanteric derotation osteotomy is a safe and effective surgical option for managing femoral anteversion and retroversion.
• The procedure leads to significant functional improvement and high patient satisfaction, despite a high rate of subsequent implant removal.