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EP281 Short-Term Outcomes of Rotational Femoral Osteotomy to Treat Abnormal Femoral Version
Abstract   Open access   Peer reviewed

EP281 Short-Term Outcomes of Rotational Femoral Osteotomy to Treat Abnormal Femoral Version

Steele McCulley, Robert Westermann, Courtney Seffker, Ashley Kochuyt, Joshua Hockman, Jenna Jensen and Michael Willey
Journal of hip preservation surgery, Vol.12(Supplement_2), pp.ii117-ii117
12/01/2025
DOI: 10.1093/jhps/hnaf069.378
PMCID: PMC12720954
url
https://doi.org/10.1093/jhps/hnaf069.378View
Published (Version of record) Open Access

Abstract

Objective Femoral version is the primary driver of hip range of motion and can cause femoroacetabular impingement (femoral retroversion) and instability (femoral anteversion). Abnormal femoral version is a common cause of persistent hip pain after arthroscopic treatment. The aim of this study was to report clinical outcomes of femoral osteotomy to correct abnormal femoral version. Methods Skeletally mature young adults indicated for diaphyseal femoral osteotomy to treat either excessive femoral anteversion or retroversion prospectively completed the 12-item International Hip Outcome Tool (iHOT-12) survey pre-operatively and 1 year post-operatively. Femoral osteotomy was performed with an open approach and repaired with a 4.5mm plate. Patients that underwent fixation with an intra-medullary nail (IMN) or underwent additional coronal plate correction were excluded. Patient demographics, femoral version measured with CT scan, laterality, previous hip surgery, concomitant hip preservation surgery, and non-union requiring revision surgery was recorded. Preoperative to 12-month iHOT scores were compared. The incidence of achieving Minimal Clinically Important Differences (MCID) was recorded (Δ iHOT >15). Differences between groups were evaluated using t-tests. Results 44 patients underwent rotational diaphyseal femoral osteotomy and completed pre-operative and 1-year post-operative iHOT-12 surveys. Average age was 22.6±7.1 years and 91.1% were female, with an average BMI of 27.17±5.23. Femoral osteotomy was performed for excessive anteversion in 59% and retroversion in 41%. Previous hip arthroscopy was performed in 38.6% of patients (2 had previous periacetabular osteotomy and 1 had undergone previous PAO with hip arthroscopy). 40 patients underwent hip arthroscopy and 5 underwent PAO during the same surgical procedure as the femoral osteotomy. One patient experienced non-union that underwent revision fixation with an IMN. Mean (SD) preoperative iHOT score was 32.7±17.8 and increased to a mean 1-year post-operative iHOT score of 64.6±28.0 (p<0.001), with 79.2% of patients meeting MCID. Conclusions Diaphyseal rotational femoral osteotomy repaired with a plate has a high union rate and improved patient-reported hip pain and dysfunction. Nearly half of these surgeries were performed for patients with previous hip preservation surgery, with 38.6% having undergone previous hip arthroscopy, possibly contributing to the lower rate of meeting MCID compared to other hip preservation surgeries.
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