Analysis of femoral version in patients undergoing periacetabular osteotomy for symptomatic acetabular dysplasia

Introduction: A paucity of information exists on the range of femoral version, its effect on hip stability, clinical examination, and presentation in patients with symptomatic acetabular dysplasia. The purpose of this study was to describe the range of version in symptomatic acetabular dysplasia, the association between femoral version and proximal femoral morphology and degree of dysplasia, and the effect of version on clinically measured hip range of motion and on preoperatively measured hip outcome scores. Methods: We reviewed 314 patients prospectively enrolled in a longitudinal clinical study on periacetabular osteotomy between January 2014 and August 2015 and measured femoral version, morphologic characteristics of the upper femur and acetabulum, and preoperative clinical outcome scores. Results: The average femoral version was 19.7 6 11.2 (range, 220 to 50). Femoral version correlated strongly with clinically measured hip range of motion but did not correlate linearly with either radiographic severity of acetabular dysplasia or preoperative symptomatology. Discussion: Despite concerns that transverse plane femoral anatomy influences the stability of the hip joint after skeletal maturity, we did not find a statistical association between femoral version and severity of dysplasia or presenting symptomatology. This finding suggests that femoral version is not a major influence on the clinical presentation of acetabular dysplasia.