Lerch Till D, Boschung Adam, Leibold Christiane, Kalla Roger, Kerkeni Hassen, Baur Heiner, Eichelberger Patric, Siebenrock Klaus A, Tannast Moritz, Steppacher Simon D, Liechti Emanuel F
Department of diagnostic, interventional and pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, Bern 3010, Switzerland.
Department of Orthopaedic Surgery, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, Bern 3010, Switzerland.
J Hip Preserv Surg. 2022 Apr 11;9(1):35-43. doi: 10.1093/jhps/hnac001. eCollection 2022 Jan.
In-toeing of the foot was associated with high femoral version (FV), while Out-toeing was associated with femoral-retroversion. Therefore, we report on (i) foot-progression-angle (FPA), (ii) prevalence of In-toeing and Out-toeing, and (iii) clinical outcome of patients treated with femoral-derotation-osteotomy (FDO). We performed a retrospective analysis involving 20 patients (20 hips) treated with unilateral FDO (2017-18). Of them, 14 patients had increased FV, 6 patients had femoral-retroversion. Follow-up time was mean 1 ± 1 years. All patients had minimal 1-year follow-up and the mean age was 29 ± 8 years. Patients with increased FV (FV > 35°) presented with positive posterior-impingement-test and mean FV was 49 ± 11° (Murphy method). Six patients with femoral-retroversion (FV < 10°) had positive anterior impingement test and mean FV of 5 ± 4°. Instrumented gait analysis was performed preoperatively and at follow-up using the Gaitrite system to measure FPA and was compared to a control group of 18 healthy asymptomatic volunteers (36 feet, mean age 29 ± 6 years). (i) Mean FPA increased significantly ( = 0.006) from preoperative 1.3 ± 7° to 4.5 ± 6° at follow-up for patients with increased FV and was not significantly different compared to the control group (4.0 ± 4.5°). (ii) In-toeing decreased from preoperatively (five patients) to follow-up (two patients) for patients with increased FV. Out-toeing decreased from preoperatively (two patients) to follow-up (no patient) for patients with femoral-retroversion. (iii) Subjective-hip-value of all patients increased significantly ( < 0.001) from preoperative 21 to 78 points at follow-up. WOMAC was 12 ± 8 points at follow-up. Patients with increased FV that underwent FDO walked with less In-toeing. FDO has the potential to reduce In-toeing and Out-toeing and to improve subjective satisfaction at follow-up.
足部内旋与股骨前倾角增大（FV）相关，而足部外旋与股骨后倾相关。因此，我们报告了（i）足进角（FPA）、（ii）内旋和外旋的患病率以及（iii）接受股骨旋转截骨术（FDO）治疗患者的临床结果。我们对20例（20髋）接受单侧FDO治疗的患者（2017 - 2018年）进行了回顾性分析。其中，14例患者FV增大，6例患者存在股骨后倾。随访时间平均为1±1年。所有患者至少随访1年，平均年龄为29±8岁。FV增大（FV>35°）的患者后撞击试验呈阳性，平均FV为49±11°（墨菲法）。6例股骨后倾（FV<10°）的患者前撞击试验呈阳性，平均FV为5±4°。术前和随访时使用步态分析系统进行仪器化步态分析以测量FPA，并与18名健康无症状志愿者组成的对照组（36足，平均年龄29±6岁）进行比较。（i）FV增大的患者，平均FPA从术前的1.3±7°显著增加（P = 0.006）至随访时的4.5±6°，与对照组（4.0±4.5°）相比无显著差异。（ii）FV增大的患者，内旋从术前的5例减少至随访时的2例。股骨后倾的患者，外旋从术前的2例减少至随访时的0例。（iii）所有患者的主观髋关节评分从术前的21分显著增加（P<0.001）至随访时的78分。随访时WOMAC评分为12±8分。接受FDO治疗的FV增大患者行走时内旋减少。FDO有可能减少内旋和外旋，并提高随访时的主观满意度。
