Femoral derotational osteotomies for version abnormalities: a mean ten-year follow-up

Listen to Brian and Lisa discuss the paper 'Femoral derotational osteotomies for version abnormalities: a mean ten-year follow-up' published in the May 2026 issue of Bone & Joint Open.

Click here to read the paper.

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Transcript

[00:00:00] Welcome back to another episode of AI Talks with Bone & Joint, brought to you by the publishers of Bone & Joint Open. Today we're discussing the paper 'Femoral derotational osteotomies for version abnormalities: a mean ten-year follow-up', published in May 2026 by B Muffly and colleagues. I'm Brian, and as always, joined by my co-host, Lisa.

Hello, everyone. Thanks for tuning in. Today, we're talking about femoral derotational osteotomies, or FDOs, which correct version abnormalities in the femur. Brian, could you start by explaining why this research was necessary?

Certainly, Lisa. Version abnormalities, such as excessive femoral anteversion or retroversion, are increasingly recognized as causes of hip pain and dysfunction. These can alter hip biomechanics, leading to joint degeneration and conditions like osteoarthritis.

How did this study aim to tackle these issues? The primary aim of the study was to assess long-term patient-reported [00:01:00] outcomes and the survivorship of FDO procedures, focusing on a mean follow-up period of ten years. They aimed to determine how effective these procedures were in reducing pain and improving function, as well as in preserving the native hip joint.

Could you walk us through the methods the researchers employed? Of course. This was a retrospective study reviewing 77 hips from 60 patients who underwent FDO between March 1997 and February 2019. They inserted an antigrade intramedullary device into the femur to correct alignment.

What criteria did they use for including patients in the study? Patients were included if they had functionally limiting hip pain, unresponsive to conservative treatments and CT scans showing excessive femoral anteversion or retroversion.

Additionally, they needed to have radiographic joint space preservation of Tönnis grade 1 or less, as well as an abnormal hip range of motion correlating with their version abnormality.

I see. Now, let's discuss the results. What were the most significant [00:02:00] findings? The results were rather promising. The modified Harris Hip Score, which measures hip function and pain, significantly improved from an average of 61.6 preoperatively to 89.7 postoperatively. About 95.2% of patients reported improvement, with most describing themselves as very much or much improved.

That's impressive. Did they observe any differences between patients with anteversion and those with retroversion? Interestingly, both groups responded well to the procedure.

For instance, 92.7% of anteverted and 85.7% of retroverted patients were satisfied with their current symptomatic state. The long-term survivorship free of conversion to arthroplasty was also remarkably high at 95% for up to 20 years.

Those are excellent outcomes. Were there any challenges or limitations noted in the study? There was some interobserver variability in hip range of motion assessment. In addition, to minimize patients' [00:03:00] exposure to ionizing radiation, postoperative CT scans to assess expected versional correction were not routinely performed. There were also changes in concurrent procedure indications over time.

It seems this study adds substantial value to the field of hip preservation. What's the main takeaway for our listeners? The main takeaway is that FDO, whether performed alone or with concurrent hip preservation procedures, significantly improves pain and function in patients with version abnormalities.

Most patients report notable postoperative improvement and satisfaction, and the procedure effectively preserves the native hip joint long-term.

Thanks for breaking that down, Brian. It's intriguing to see how surgical techniques and long-term data can offer new hope for those suffering from these conditions.

Indeed and that wraps up today's episode of AI Talks with Bone & Joint. Join us next time for another deep dive into the latest orthopaedic research. Thanks for listening.