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Nelson CT, Reiter CR, Harris M, Edge C, Satalich J, O'Neill C, Cyrus J, Vap A. Femoral rotational osteotomy for femoroacetabular impingement: A systematic review. J Orthop 2024; 50:139-148. [PMID: 38283872 PMCID: PMC10818154 DOI: 10.1016/j.jor.2023.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 12/17/2023] [Indexed: 01/30/2024] Open
Abstract
Purpose To synthesize existing literature regarding the indications and outcomes of femoral rotational osteotomies (FDO) for femoroacetabular impingement (FAI) due to. Methods Medline, Cochrane, and Embase were searched using keywords "femoroacetabular impingement", "rotational osteotomy" and others to identify FAI patients undergoing FDO. Double-screened studies were reviewed by blinded authors according to inclusion criteria. Data from full texts was extracted including study type, number of patients, sex, mean age, surgical indication, type of dysplasia, associated pathology, surgical technique, follow-up, and pre-op/post-op evaluations of the following: impingement test, femoral version (FV), 'other angles measured', outcome scores, range of motion (ROM). Results 7 studies including 91 patients (97 FDO surgeries), 73 females (80 %) with mean age of 28.3 years, and follow-up mean of 2.44 ± 2.83 years. Pain or impingement was the most common clinical indication, while others included aberrant FV and ROM measurements for both anteverted and retroverted femurs. There were reports of FDO being performed with concomitant procedures addressing other pathology. Various outcome scores and ROM measurements showed postoperative improvement after FDO. Complication data was sparse, preventing aggregation. The rate of unplanned reoperation was 40 % (where reported), with 'hardware removal' being the most common. Conclusions FDO is effective in treating FAI due to increased FV, improving clinical symptoms, and potentially delaying articular degeneration. Hardware removal surgery remains an inherent risk in undergoing FDO. Further work is needed to discover indications warranting FDO as a primary treatment versus hip arthroscopy. Level of evidence This review contains 4 studies with Level IV evidence and 3 studies with Level III evidence.
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Affiliation(s)
- Chase T. Nelson
- Virginia Commonwealth University School of Medicine, Virginia Commonwealth University, VCU Medical Center, 1201 E Marshall St #4-100, Richmond, VA, 23298, USA
| | - Charles R. Reiter
- Virginia Commonwealth University School of Medicine, Virginia Commonwealth University, VCU Medical Center, 1201 E Marshall St #4-100, Richmond, VA, 23298, USA
| | - Matthew Harris
- Virginia Commonwealth University School of Medicine, Virginia Commonwealth University, VCU Medical Center, 1201 E Marshall St #4-100, Richmond, VA, 23298, USA
| | - Carl Edge
- Department of Orthopaedic Surgery, Virginia Commonwealth University Hospital, Box 980153, Richmond, VA, 23298-0153, USA
| | - James Satalich
- Department of Orthopaedic Surgery, Virginia Commonwealth University Hospital, Box 980153, Richmond, VA, 23298-0153, USA
| | - Conor O'Neill
- Department of Orthopaedic Surgery, Duke Health, 200 Trent Dr Ste 1F, Durham, NC, 27710, USA
| | - John Cyrus
- Health Sciences Library, MCV Campus at Virginia Commonwealth University, 509 N. 12th St., Box 980582, Richmond, VA, 23298-0582, USA
| | - Alexander Vap
- Department of Orthopaedic Surgery, Virginia Commonwealth University Hospital, Box 980153, Richmond, VA, 23298-0153, USA
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