The Role of Tibial and Femoral Rotational Torsion Abnormalities in the Treatment of Patellofemoral Dysfunction

Cooper, Trenton; Arendt, Elizabeth A.

doi:10.1007/978-3-662-61097-8_7

Cited by 1 publication

(1 citation statement)

References 78 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A tibial torsion normally changes from a minimal internal torsion at birth to 15–20° of an external torsion [ 4 , 15 ]. However, a wide range of mean values was reported by the previous studies, partly due to the disparate measurement methods and reference points used [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Tibial derotation osteotomies are effective in improving pain and function and avoiding hip arthroscopy in patients with hip pain—a short-term follow-up

Goriainov,

Farook,

Vanhegan

et al. 2023

Journal of Hip Preservation Surgery

View full text Add to dashboard Cite

The primary objective was to determine short-term clinical outcomes following distal tibial derotation osteotomy (DTDO) performed to manage hip pain in the presence of tibial maltorsion and to review how co-existing pathomorphology affected the management. All patients undergoing DTDO for hip pain with tibial rotational deformities recognized as the predominant aetiology were included. Normal tibial torsion range was assumed as 0–40°, measured by trans-malleolar line relative to femoral posterior condyles. All patients had a positive hip impingement test Flexion Adduction Internal Rotation test (FADIR). The patients older than 50 years or presenting with degenerative joint changes and neuromuscular conditions were excluded. Associated ipsilateral MRI-defined intra-articular pathomorphology (cam/pincer), non-cam/pincer-related labral tears and abnormal combined femoral/acetabular version (McKibbin index) were noted. Pre-operative and post-operative functional outcomes were analysed. Thirty-two patients underwent DTDO. Mean tibial torsion was 48.8° (41–63°), average age was 27 years (18–44), and average follow-up was 30 months (16–45). Nine patients (28%) had a co-existing cam/pincer, and eight patients (25%) had an excessive McKibbin index (51–76°). Overall, 63% of all patients (including 54% of patients with co-existing pathology) experienced significant hip functional improvement following DTDO alone. Pre-operative vs 12 months post-operative scores were calculated as follows: International Hip Outcome Tool-12—41 vs 67 (P < 0.01); Hip Outcome Score Activities of Daily Living Scale—47 vs 70 (P < 0.05); and Hip Outcome Score Sport Scale—36 vs 64 (P < 0.05). Patients with hip pain frequently present with a combination of tibial and/or femoral rotational deformity and cam/pincer lesions. It is important to consider tibial maltorsion as an aetiology of hip pain. Tibial derotation with DTDO results in significant clinical and functional recovery within 12 months in symptomatic hip impingement patients even in the presence of co-existing pathomorphology.

show abstract

Section: Discussionmentioning

confidence: 99%