TY - JOUR
T1 - Femoral Version and Tibial Torsion are Not Associated with Hip or Knee Arthritis in a Large Osteological Collection
AU - Weinberg, Douglas S.
AU - Park, Paul J.
AU - Morris, William Z.
AU - Liu, Raymond W.
N1 - Publisher Copyright:
Copyright © 2015 Wolters Kluwer Health, Inc. All rights reserved.
PY - 2017
Y1 - 2017
N2 - Background: Tibial torsion and femoral anteversion are common rotational abnormalities in children, and their courses are most often benign and self-resolving. Although neither usually requires surgical treatment, the decision to perform a derotational osteotomy is usually based on the degree of functional impairment. Neither condition is thought to influence the development of osteoarthritis of the hip or knee; however, to date there have been no large scale studies confirming this. Methods: Tibial torsion and femoral version in 1158 cadaveric tibiae and femora were measured using a camera setup based on previously described radiographic landmarks. Any specimens with obvious traumatic, rheumatic, or metabolic abnormalities were excluded. Degenerative joint disease of the hip and knee were each graded from 0 to 6. Correlations between tibial torsion, femoral version, age, race, and sex with osteoarthritis of the hip and knee joints were evaluated with multiple regression analysis. Results: The mean and SDs of tibial torsion and femoral anteversion were 7.9±8.8 and 11.4±12.0 degrees, respectively. African Americans had significantly increased tibial torsion (5.1±8.7 vs. 9.2±8.5 degrees, P<0.0005) and greater femoral anteversion (14.1±11.9 vs. 10.2±11.8 degrees, P<0.0005) compared with whites. The average grades for hip and knee osteoarthritis were 3.1±1.4 and 2.7±1.4. Using multiple regression analysis neither tibial torsion nor femoral version were independent predictors of hip or knee arthritis (P>0.05 for all). Discussion: This study confirmed previously reported differences in the rotational profiles between races and sexes. However, neither tibial torsion nor femoral anteversion had a significant influence on the development of arthritis of the hip or knee. Clinical Relevance: These results support the practice of treating tibial torsion and femoral anteversion based on the symptomatology of the patient. Parents of asymptomatic children can be reassured that long-term consequences are unlikely.
AB - Background: Tibial torsion and femoral anteversion are common rotational abnormalities in children, and their courses are most often benign and self-resolving. Although neither usually requires surgical treatment, the decision to perform a derotational osteotomy is usually based on the degree of functional impairment. Neither condition is thought to influence the development of osteoarthritis of the hip or knee; however, to date there have been no large scale studies confirming this. Methods: Tibial torsion and femoral version in 1158 cadaveric tibiae and femora were measured using a camera setup based on previously described radiographic landmarks. Any specimens with obvious traumatic, rheumatic, or metabolic abnormalities were excluded. Degenerative joint disease of the hip and knee were each graded from 0 to 6. Correlations between tibial torsion, femoral version, age, race, and sex with osteoarthritis of the hip and knee joints were evaluated with multiple regression analysis. Results: The mean and SDs of tibial torsion and femoral anteversion were 7.9±8.8 and 11.4±12.0 degrees, respectively. African Americans had significantly increased tibial torsion (5.1±8.7 vs. 9.2±8.5 degrees, P<0.0005) and greater femoral anteversion (14.1±11.9 vs. 10.2±11.8 degrees, P<0.0005) compared with whites. The average grades for hip and knee osteoarthritis were 3.1±1.4 and 2.7±1.4. Using multiple regression analysis neither tibial torsion nor femoral version were independent predictors of hip or knee arthritis (P>0.05 for all). Discussion: This study confirmed previously reported differences in the rotational profiles between races and sexes. However, neither tibial torsion nor femoral anteversion had a significant influence on the development of arthritis of the hip or knee. Clinical Relevance: These results support the practice of treating tibial torsion and femoral anteversion based on the symptomatology of the patient. Parents of asymptomatic children can be reassured that long-term consequences are unlikely.
KW - femoral anteversion
KW - hip osteoarthritis
KW - knee osteoarthritis
KW - rotational deformity
KW - tibial torsion
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U2 - 10.1097/BPO.0000000000000604
DO - 10.1097/BPO.0000000000000604
M3 - Article
C2 - 26214325
AN - SCOPUS:85011866911
SN - 0271-6798
VL - 37
SP - e120-e128
JO - Journal of Pediatric Orthopaedics
JF - Journal of Pediatric Orthopaedics
IS - 2
ER -