Summary: Femoral and tibial derotation osteotomies are effective interventions in management of relevant hip and knee symptoms resulting from rotational deformities.

Introduction.
Rotational profile of femur and tibia significantly contribute to the kinematics of hip and knee joints. Femoral version abnormalities lead to impingement syndromes, hip articular damage and periarticular muscle imbalance, gait disturbances, as well as dysfunction of patello-femoral joint (PFJ). Although the role of tibial torsion derangements in PFJ dysfunction is evident, their contribution to hip symptoms, especially with certain activities, is less well understood. The treatment of femoral and tibial rotational deformities includes Proximal Femoral Derotation Osteotomy (PFDO) and Distal Tibial Derotation Osteotomy (DTDO), respectively. We aimed to determine the clinical effectiveness of these interventions in improving patients’ hip and knee symptoms.

Materials.
We performed a retrospective review of prospectively collected data in patients that underwent PFDO and DTDO between 2018-2020. PFDO was routinely stabilised using intramedullary nail (Metatan, S&N) and DTDO with tibial plate (EVOS, S&N). Pre-operative and interval post-operative functional outcomes were analysed and correlated. Functional outcomes included international hip outcome tool (iHOT12), hip and knee outcome score activities of daily living scale (HOS ADLS and KOS ADLS, respectively) and sport scale (HOS SS and KOS SS, respectively), non-arthritic hip score (NAHS) and anterior knee pain or Kujala score (AKP). HOS and KOS scores included additional graphical scores.

Results.
We identified 22 patients that underwent PFDO (13 females) and 30 – DTDO (27 females). Average age was 24 years (17-38) and 26 years (18-44) in PFDO and DTDO cohorts, respectively. Average follow-up was 18 months (2-35). Statistical difference between pre-operative and post-operative scores was achieved at 18 and 12 months for PFDO and DTDO, respectively.
To date, there were two non-unions in PFDO group, one treated with Exogen ultrasound device and one with exchange nailing. Three further PFDO required nail dynamization. There were no other significant post-operative complications.
Pre-operative vs 18 months post-operative scores for PFDO were 33 vs 88 for iHOT 12; 55 vs 91 for HOS ADLS and 46 vs 92 for HOS ADLS graphical; 44 vs 86 for HOS SS and 39 vs 80 for HOS SS graphical; and 57 vs 89 for NAHS. Pre-operative vs 12 months post-operative scores for DTDO were 38 vs 97 for iHOT 12; 58 vs 94 for KOS ADLS and 61 vs 95 for KOS ADLS graphical; 52 vs 96 for KOS SS and 40 vs 96 for KOS SS graphical; and 58 vs 94 for AKP.

Conclusions.
Femoral and tibial rotational deformities are important to be recognised as contributing factors to hip and knee pain. Derotation osteotomies are effective interventions in management of relevant symptoms resulting from rotational deformities. Recovery is more rapid following tibial osteotomy, although the initial level of pre-operative function is higher in patients with tibial torsional abnormalities. Nevertheless, both osteotomies can lead to a functional recovery to near normal level at the maximum of 18 months.

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Amniotic Suspension Allograft Injection For Hip Osteoarthritis: Prospective Pilot Study With 1 Year Follow Up Abstract Presentation 5 minutes Marc R. Safran, MD, Prof., UNITED STATES Molly Claire Meadows, MD, UNITED STATES Katia Elisman, BS, UNITED STATES Shane Nho, MD, MS, UNITED STATES
Defining Sex-Based Outcomes Following Hip Arthroscopy In Patients With Borderline Hip Dysplasia. ePoster Presentation Benjamin Saks, MD, UNITED STATES James Fox, BBA, UNITED STATES Jade S Owens, BS, UNITED STATES Andrew Jimenez, MD, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Payam William Sabetian, MD, GUATEMALA Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Outcome Measures After Proximal Hamstring Repair: A Systematic Review ePoster Presentation Tara Reza, MPH, UNITED STATES Andre Gordon Perez-Chaumont, BS, UNITED STATES Andrew J Hinkle, BS, UNITED STATES Symone M Brown, MPH, UNITED STATES Mary K. Mulcahey, MD, UNITED STATES
Arthroscopic Tendon Release for Iliopsoas Impingement after Total Hip Arthroplasty ePoster Presentation Michael Andreas Finsterwald, MD, AUSTRALIA Georgina Waters, MD, AUSTRALIA Jay R. Ebert, PhD, AUSTRALIA Christopher W. Jones, FAOrthA FRACS PhD MBBS(Hons) BEng(Hons) BCom, AUSTRALIA Piers Yates, MBBS(Hons) BSc(Hons) MRCS(Eng) FRCS(Tr & Orth) FRA, AUSTRALIA Peter Alberto D'Alessandro, MBBS Hons. (UWA) FRACS FAOrthA, AUSTRALIA
Hip Labrum Reconstruction With A Polyurethane Scaffold: A Preliminary Report Of 3 Cases ePoster Presentation Bruno Capurro, MD, PhD., SPAIN Marc Tey Pons, MD, PhD, MScs, SPAIN Raul Torres, MD, SPAIN Fernando Marques, MD, PhD., SPAIN Alfonso León, MD, PhD., SPAIN Oliver Marín-Peña, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Traumatic Hip Dislocations In The Pediatric Patient: Injury Patterns, Need For Axial Imaging, Outcomes, And Selective Hip Arthroscopy Abstract Presentation 5 minutes Cliff Willimon, MD, UNITED STATES Anthony Egger, MD, UNITED STATES Crystal A. Perkins, MD, UNITED STATES
Midterm Outcomes Following Hip Labral Augmentation Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Rui Soares, BS, UNITED STATES Justin W. Arner, MD, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Maitland Martin, BS, UNITED STATES Spencer M Comfort, BS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
Arthroscopy For Gunshot Wounds To The Hip ePoster Presentation Jorge Figueras, BS, UNITED STATES J P Ertl, MD, UNITED STATES Karchi Ertl, BS, UNITED STATES Brian Mullis, MD
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
Correlation Between Arthro-MRI Results And Intraoperative Hip Arthroscopy Findings In Fai Syndrome ePoster Presentation Christian Sobau, MD, GERMANY Konstantinos Tramountanis, MD, GERMANY Wolfgang Miehlke, MD, GERMANY Alexander Zimmerer, MD, GERMANY
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
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
Endoscopic Shelf Acetabuloplasty Concomitant With Labral Repair, Cam Osteoplasty, And Capsular Plication For Treating Artistic Dancers In The Setting Of Acetabular Dysplasia: A Case Series Abstract Presentation 4 minutes Soshi Uchida, MD, PhD, JAPAN Yoichi Murata, MD, JAPAN Hajime Utsunomiya, MD, PhD, JAPAN Tsukamoto Manabu, MD, PhD, JAPAN Akihisa Hatakeyama, MD, JAPAN Shiho Kanezaki, MD, PhD, JAPAN Akinori Sakai, MD, PhD, JAPAN
Labral Size Correlates With Increasing Intraarticular Damage At Time Of Arthroscopy In Borderline Dysplastic Patients ePoster Presentation Jacob Shapira, MD, UNITED STATES Jeffrey Chen, BA, UNITED STATES Mitchell Yelton, BS, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES David R. Maldonado, MD, UNITED STATES Mitchell Meghpara, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES

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Are Femoral And Tibial Derotation Osteotomies Effective In Improving Hip And Knee Pain And Function?

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