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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Superior Outcomes With Routine Capsular Repair In Hip Arthroscopy Abstract Presentation 5 minutes Austin M Looney, MD, UNITED STATES Spencer M Comfort, BS, UNITED STATES Patrick T Connolly, BS, UNITED STATES Julia E McCann, MD, UNITED STATES Andrew Curley, MD, UNITED STATES William F. Postma, MD, 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
Promis Mobility: Evaluation Of The Lower Extremity-Specific Instrument In A Sports Medicine Hip Registry ePoster Presentation Molly A Day, MD, UNITED STATES Ryan S. Selley, MD, UNITED STATES Kyle Hancock, MD, UNITED STATES Reena Olsen, BS, UNITED STATES Danyal H. Nawabi, MD, FRCS(Orth), UNITED STATES Benedict U. Nwachukwu, MD, MBA, UNITED STATES Stephanie S Buza, MD, UNITED STATES Anil S. Ranawat, MD, UNITED STATES Bryan T. Kelly, MD, UNITED STATES
Segmental Labral Reconstruction With A Polyurethane Scaffold: Assessment Of Femoro-Acetabular Contact Mechanics Abstract Presentation 5 minutes Bruno Capurro, MD, PhD., SPAIN Marc Tey, MD, PhD., SPAIN Francisco Reina, MD, PhD, SPAIN Anna Carrera, MD, PhD., SPAIN Mauricio Gidi, MD, SPAIN Joan Carles Monllau, MD, PhD, Prof., SPAIN
Hip Osteochondroplasty May Benefit The Non-Ideal Patient With Femoroacetabular Impingement: Analysis From The Embedded Prospective Cohort Of The First Trial Abstract Presentation 6 minutes Mahmoud Almasri, MD, FRCSC, UNITED STATES Nicole Simunovic, MSc, CANADA Diane Heels-Ansdell, MSc, CANADA Olufemi R. Ayeni, MD, PhD, MSc, FRCSC, CANADA FIRST Investigators, MD, CANADA
Endoscopic Iliotibial Band Release During Hip Arthroscopy For Femoroacetabular Impingement Syndrome And External Snapping Hip Had Better Patient-Reported Outcomes: A Retrospective Comparative Study Abstract Presentation 5 minutes 春宝李, 医学博士，博士, CHINA Shanxing Zhang, MD, CHINA
Mortality After Hip Or Knee Arthroplasty For Osteoarthritis In Chile ePoster Presentation Maximiliano Andres Barahona, MD, MSc, CHILE Cristian Barrientos, MD, CHILE Alvaro Martinez, MD, CHILE Julian Brañes, MD, CHILE Juan Pablo Prieto, MD, CHILE Jaime Hinzpeter, MD, CHILE
Risk Of Conversion To Arthroplasty Following Hip Arthroscopy: Validation Of A Published Risk Score Using An Independent, Prospectively Collected Database Abstract Presentation 4 minutes Mario Hevesi, MD, PhD, UNITED STATES Devin Leland, MD, UNITED STATES Philip Joseph Rosinsky, MD, UNITED STATES Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES David E. Hartigan, MD, UNITED STATES Bruce A. Levy, MD, UNITED STATES Aaron J. Krych, MD, UNITED STATES
Hip Arthroscopic Portals:A New Approach Through Accessory Portals Established Within 3Cm Around Anterolateral Portal ePoster Presentation Kiran Kumar Shah, MD, NEPAL
Comparison Of Pull-Out Strength Following Ligamentum Teres Reconstruction In The Hip: Peek Corkscrew Suture Anchor Versus Cortical Button Fixation: A Cadaveric Study. Abstract Presentation 5 minutes Ajay C. Lall, MD, MS, FAAOS, UNITED STATES Hari Krishna Ankem, MD, UNITED STATES Samantha Diulus, BS, UNITED STATES Benjamin G. Domb, MD, UNITED STATES
Midterm Outcomes After Arthroscopic Hip Capsular Reconstruction Using Iliotibial Band Allograft Abstract Presentation 4 minutes Joseph J. Ruzbarsky, MD, UNITED STATES Max Seiter, MD, UNITED STATES Rui Soares, BS, UNITED STATES Lauren Pierpoint, PhD, UNITED STATES Karen K. Briggs, MPH, MBS, UNITED STATES Marc J. Philippon, MD, UNITED STATES
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
A Systematic Review Of Terminology, Surgical Techniques, Preoperative Diagnostic Measures, And Geographic Differences In The Treatment Of Athletic Pubalgia/Sports Hernia/Core Muscle Injury/Inguinal Disruption ePoster Presentation Matthew J. Kraeutler, MD, UNITED STATES Omer Mei-Dan, MD, UNITED STATES John W. Belk, BA, UNITED STATES Christopher M. Larson, MD, UNITED STATES Toghrul Talishinskiy, MD, UNITED STATES Anthony Scillia, 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

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

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