Long-term Clinical Outcomes after Isolated Intertrochanteric Rotational Osteotomy for Pathological Femoral Torsion: A...

Intertrochanteric rotational osteotomy (ITO) is a joint-preserving option in selected patients with symptomatic femoral torsional abnormalities. Functional results beyond 15 years are scarce. This study describes the long-term functional and patient-reported status after isolated ITO; it is not designed to demonstrate efficacy or superiority.

A monocentric retrospective cohort of 60 patients was evaluated 16.6 years after isolated rotational or derotational osteotomy. Functional outcomes were assessed using HHS, WOMAC, EQ-5D-5L, and clinical examination. Exploratory multivariable regression was used to assess potential associations with functional and patient-reported outcome parameters.

More than 75% of patients achieved good to excellent outcomes (mean HHS 85 ± 15). Mean WOMAC score was 11 ± 13, and mean EQ-5D-5L index was 0.843 ± 0.189. No conversion to total hip arthroplasty was observed during follow-up. Female sex was associated with higher WOMAC scores and lower EQ-5D-5L values.

In this retrospective single-arm cohort, isolated intertrochanteric rotational or derotational osteotomy was accompanied by stable functional and patient-reported values over a mean of 16,6 years, with no conversion to total hip arthroplasty during follow-up. Sex and the documented rotational correction angle were associated with selected patient-reported outcomes. Because of the retrospective design, the absence of a control group, the absence of preoperative score values, and the absence of standardised radiological torsion and follow-up imaging, the data do not support any statement on efficacy, on prevention of degenerative change, or on superiority over alternative approaches. These results describe the long-term functional status of a clinically documented cohort.