Clinical Report: Version Abnormalities in Symptomatic Femoroacetabular Impingement

Overview

This systematic review analyzed 43 studies involving 8861 hips with symptomatic femoroacetabular impingement (FAI) and found that more than one-third of patients exhibit abnormalities in femoral or acetabular version. The findings highlight the prevalence of version and torsional deformities in FAI and their potential impact on clinical outcomes.

Background

Femoroacetabular impingement (FAI) is characterized by abnormal contact between the femur and acetabulum, leading to hip pain and restricted motion. FAI is classified into cam, pincer, or mixed types based on morphological abnormalities. Recent research has focused on the role of femoral and acetabular version, as well as tibial torsion, in FAI pathophysiology and treatment outcomes. Understanding these version abnormalities is critical for optimizing surgical decision-making and improving patient prognosis.

Data Highlights

Key Findings

• More than one-third of individuals with symptomatic FAI have abnormal femoral or acetabular version.
• Abnormal femoral and/or acetabular version was found in 68% of hips presenting with FAI or dysplasia in one large study.
• Abnormal tibial torsion was identified in 42% of patients with FAI and dysplasia.
• Version abnormalities correlate significantly with hip internal and external rotation.
• These abnormalities may influence outcomes following arthroscopic intervention for FAI.
• There is a lack of prior systematic reviews characterizing version and torsional deformities in FAI, underscoring the importance of this study.

Clinical Implications

Clinicians should consider assessing femoral and acetabular version as well as tibial torsion in patients presenting with symptomatic FAI, as these abnormalities are common and may affect surgical planning and outcomes. Recognition of version abnormalities can guide more tailored interventions and potentially improve prognosis. Incorporating version measurements into routine evaluation may optimize decision-making for arthroscopic or other surgical treatments.

Conclusion

Version abnormalities of the femur and acetabulum are prevalent in symptomatic FAI and represent important factors influencing hip mechanics and treatment outcomes. Systematic evaluation of these deformities should be integrated into clinical practice to enhance patient management.

References

1. Ganz et al. 2003 -- Femoroacetabular Impingement and Osteoarthritis
2. Ng et al. -- Femoral Version in Symptomatic Cam FAI
3. Shin et al. -- Correlation of Combined Acetabular and Femoral Version with Hip Rotation
4. Lerch et al. -- Abnormal Femoral and Acetabular Version in FAI and Dysplasia
5. Lerch et al. -- Tibial Torsion in FAI and Dysplasia