Summary: Proximal Femoral malrotation correction frequently successfully resolves hip impingement even in the presence of intra-articular CAM/pincer pathomorphology.

Introduction.
It is recognised that hip impingement can be caused by intra-articular pathology (CAM/pincer) and/or a combined femoral/acetabular version abnormality. The latter is treated based on the severity of predominant component. Proximal Femoral (PF) malrotation treatment includes Proximal Femoral Derotation Osteotomy (PFDO). We aimed to determine PFDO clinical effectiveness in patients with hip symptoms.

Materials.
A review of patients undergoing PFDO between 2018-2020. Sub-trochanteric PFDO was routinely stabilised with IM nail (Metatan,S&N). We reviewed our management of femoral torsion and associated MRI-defined intra-articular pathomorphology: CAM/pincer ? labral tear and non-CAM/pincer-related labral tears. Combined femoral/acetabular version was assessed using McKibbin Index (MI) (normal ranges: MI–20-50o, acetabular version–10-25o, PF–10-25o). If presenting symptoms resolved, patients were discharged at 18months.

Results.
22 patients underwent PFDO for hip pain. Average age–24years (17-38), average follow-up–20months (3-36).

Observed prevalence of version abnormalities in our cohort were:
• MI
o 8–Excessive retroversion (range -5–5o,median–3o),
o 14–Excessive anteversion (51–67o,median–55o);
• Acetabulum
o 11–Relative retroversion (-2–9o,median–4o),
o 11–Normal (11–23o,median–19o);
• PF
o 8–Relative retroversion (-8–5o,median–0o),
o 14–Excessive anteversion (26–54o,median–34o).

Overall, 12 patients settled post-PFDO and were discharged at 18months follow-up.

Of 10 patients with associated MRI-defined CAM/pincer pathomorphology
• 4 had hip arthroscopy prior to PFDO (discharged)
• 1 required hip arthroscopy post-PFDO
• 5 – no hip arthroscopy required (2–discharged, 3– <18months follow-up).

Conclusion.
Patients with hip impingement present with high prevalence of rotational malalignment. Hip arthroscopy for intra-articular pathology prior to malrotation correction is likely to fail. Primary correction of malrotation is crucial and leads to symptom resolution in significant proportion of patients.

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Can Hip Pain Be Treated With Tibial Malrotation Correction? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Mohamed Zubair Farook, MBBS, D.Ortho, FRCS (Orth), UNITED KINGDOM Rajiv Kaila, MRCS, MSc, MFSEM(UK), FEBOT, UNITED KINGDOM Tom CB Pollard, MD, FRCS (Tr & Orth), UNITED KINGDOM Antonio J. M. D. Andrade, MB BS, M.Sc., FRCS(Tr&Orth), UNITED KINGDOM
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Evaluation of endoscopically gluteus medius repair in patients with Femoro-acetabular impingement and labrum detachment ePoster Presentation George D. Tsikouris, MD, GREECE Nikolaos D. Gravvanis, MD, GREECE Georgia S. Dedousi, MD, GREECE Panagiota Vlaserou, BSc in Physiotherapy, MSc Biomedical Engineer, GREECE Fanis P. Papadakis, BSc, MSc(cand.), GREECE Ioannis K. Antonopoulos, GREECE Vassilis N. Psychoyios, MD, GREECE Theodoros G. Troupis, Prof, GREECE
Is Arthroscopy An Adequate Therapy For All Borderline Dysplastic Hips? Correlation Between Radiologic Findings And Clinical Outcomes Abstract Presentation 6 minutes Alexander Zimmerer, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Christian Sobau, MD, GERMANY
Does MRI Scan Enable Optimally Informed Pre-Operative Planning In Hip Arthroscopy? Abstract Presentation 5 minutes Vitali Goriainov, FRCS (Orth), BM, PhD, MSc, UNITED KINGDOM Fadi Hindi, BM, MRCS, UNITED KINGDOM Andrew Langdown, BSc MB ChB FRCS(Tr&Orth), UNITED KINGDOM
Similar Joint Space Measurements Are Obtained With Supine And Weightbearing Anteroposterior Pelvis Radiographs: Results Of A Prospective Study Abstract Presentation 5 minutes Blake M. Bodendorfer, MD, UNITED STATES Vishal A. Mehta, DO, UNITED STATES Austin M Looney, MD, UNITED STATES Kenneth Tepper, MD, UNITED STATES
Assessing The Risk Of Osteoarthritis Progression And Femoral Head Collapse Following Hip Corticosteroid/Anesthetic Injection Abstract Presentation 5 minutes Paul F Abraham, BS, UNITED STATES Nathan Varady, MD, MBA, UNITED STATES Kirstin Small, MD, UNITED STATES Nehal Shah, MD, UNITED STATES Luis S Beltran, MD, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES Wendy Madeline Meek, BBA, UNITED STATES Scott D Martin, MD, UNITED STATES
Treatment Modalities And Outcomes Following Acetabular Fractures In The Elderly: A Systematic Review Abstract Presentation 3 minutes Brian McCormick, MD, UNITED STATES Joseph Serino, MD, UNITED STATES Sebastian Orman, MD, UNITED STATES Alex R. Webb, MD, UNITED STATES David X. Wang, MD, UNITED STATES Sharri Mortenson, MD, UNITED STATES Arvind Von Keudell, MD, UNITED STATES
No Association Between Intrauterine Contraceptive Devices and Musculoskeletal Hip Joint Pain Abstract Presentation 5 minutes Nathan Varady, MD, MBA, UNITED STATES Paul F Abraham, BS, UNITED STATES Michael Peter Kucharik, BS, UNITED STATES Christopher T Eberlin, BS, UNITED STATES David Freccero, MD, UNITED STATES Eric L. Smith, MD, UNITED STATES Scott D Martin, MD, UNITED STATES
Surgical Treatment of High-Grade Acute Intramuscular Hamstring Tendon Injuries in Athletes ePoster Presentation Randeep Singh Aujla, MBChB ChM FRCS (Tr&Orth) MFSEM, UNITED KINGDOM Steven Cecchi, BSc (Hons), MBBS, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA Peter T. Annear, FRACS(Orth), AUSTRALIA
Cleft Sign and Bone Marrow Edema of the Pubic Synthesis are Associated with Sports Activity and Bony Morphology Related to Femoroacetabular Impingement in Symptomatic Patients with Labral Tears: A Cohort Study Abstract Presentation 5 minutes Keisuke Nakayama, MD, PhD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Soshi Uchida, MD, PhD, JAPAN
Solving Social Inequality In Surgical Outcomes By Combining Standardized Treatment And Individualized Patient Education ePoster Presentation Benjamin Saks, MD, UNITED STATES Vivian Ouyang, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Long Term Outcomes After Arthroscopic Treatment Of Femoroacetabular Impingement For Patients With Borderline Dysplasia Abstract Presentation 4 minutes Ryan S. Selley, MD, UNITED STATES Molly A Day, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Stephanie S Buza, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES
Outcomes of Proximal Hamstring Tendon Repair in Patients Older than 50 Years of Age Abstract Presentation 5 minutes Alexander Rainer Manuel Bitzer, MD, UNITED STATES Daniel Hurwit, UNITED STATES Julian Joseph Sonnenfeld, MD, UNITED STATES Durham Weeks, MD, UNITED STATES
The Surgeon Mentor Program: Outcomes of Total Hip Arthroplasty via the Direct Anterior Approach ePoster Presentation Christopher J. Wilson, A/Prof, MBChB, MRCS, FRACS, PhD, AUSTRALIA Melinda Jiang, MD, AUSTRALIA Mark Inglis, FRACS BMBS B Med Sci FOrthoA, AUSTRALIA David Morris, MD, AUSTRALIA Nathan Eardley-Harris , MBBS, MClinSc, AUSTRALIA
A Prospective Comparison Of Groin-Related Complications Following Hip Arthroscopy With Versus Without A Perineal Post ePoster Presentation Iciar M Davila Castrodad, MD, UNITED STATES Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES Anthony Scillia, UNITED STATES

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Not Every Hip Impingement Requires Hip Arthroscopy.

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