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Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation

PURPOSE: Slipped capital femoral epiphysis is a common pediatric hip disease and was associated with femoral retroversion, but femoral version was rarely measured. Therefore, mean femoral version, mean femoral neck version, and prevalence of femoral retroversion were analyzed for slipped capital fem...

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Autores principales: Lerch, Till D, Kaim, Tilman, Hanke, Markus S, Schmaranzer, Florian, Steppacher, Simon D, Busch, Jasmin D, Novais, Eduardo N, Ziebarth, Kai
Formato: Online Artículo Texto
Lenguaje:English
Publicado: SAGE Publications 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080244/
https://www.ncbi.nlm.nih.gov/pubmed/37034201
http://dx.doi.org/10.1177/18632521221149044
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author Lerch, Till D
Kaim, Tilman
Hanke, Markus S
Schmaranzer, Florian
Steppacher, Simon D
Busch, Jasmin D
Novais, Eduardo N
Ziebarth, Kai
author_facet Lerch, Till D
Kaim, Tilman
Hanke, Markus S
Schmaranzer, Florian
Steppacher, Simon D
Busch, Jasmin D
Novais, Eduardo N
Ziebarth, Kai
author_sort Lerch, Till D
collection PubMed
description PURPOSE: Slipped capital femoral epiphysis is a common pediatric hip disease and was associated with femoral retroversion, but femoral version was rarely measured. Therefore, mean femoral version, mean femoral neck version, and prevalence of femoral retroversion were analyzed for slipped capital femoral epiphysis patients. METHODS: A retrospective observational study evaluating preoperative hip magnetic resonance imaging of 27 patients (49 hips) was performed. Twenty-seven untreated slipped capital femoral epiphysis patients (28 slipped capital femoral epiphysis hips and 21 contralateral hips, age 10–16 years) were evaluated (79% stable slipped capital femoral epiphysis, 22 patients; 43% severe slipped capital femoral epiphysis, 12 patients). Femoral version was measured using Murphy method on magnetic resonance imaging (January 2014–December 2021, rapid bilateral 3-dimensional T1 water-only Dixon-based images of pelvis and knee). All slipped capital femoral epiphysis patients underwent surgery after magnetic resonance imaging. RESULTS: Mean femoral version of slipped capital femoral epiphysis patients (−1° ± 15°) was significantly (p < 0.001) lower compared to contralateral side (15° ± 14°). Femoral version of slipped capital femoral epiphysis patients had significantly (p < 0.001) wider range from –42° to 35° (range 77°) compared to contralateral side (−5° to 44°, range 49°). Mean femoral neck version of slipped capital femoral epiphysis patients (6° ± 15°) was lower compared to contralateral side (11° ± 12°). Fifteen slipped capital femoral epiphysis patients (54%) had absolute femoral retroversion (femoral version < 0°). Six of the 12 hips (50%) with severe slips and 4 of the 8 hips (50%) with mild slips had absolute femoral retroversion (femoral version < 0°). Ten slipped capital femoral epiphysis patients (40%) had absolute femoral neck retroversion (femoral neck version < 0°). CONCLUSION: Although slipped capital femoral epiphysis patients showed asymmetrically lower femoral version compared to contralateral side, there was a wide range of femoral version, underlining the importance of patient-specific femoral version analysis on preoperative magnetic resonance imaging. Absolute femoral retroversion was prevalent in half of slipped capital femoral epiphysis patients, in half of severe slipped capital femoral epiphysis patients, and in half of mild slipped capital femoral epiphysis patients. This has implications for anterior hip impingement and for surgical treatment with in situ pinning or femoral osteotomy (e.g. proximal femoral derotation osteotomy) or other hip preservation surgery.
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spelling pubmed-100802442023-04-08 Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation Lerch, Till D Kaim, Tilman Hanke, Markus S Schmaranzer, Florian Steppacher, Simon D Busch, Jasmin D Novais, Eduardo N Ziebarth, Kai J Child Orthop Hip disorders PURPOSE: Slipped capital femoral epiphysis is a common pediatric hip disease and was associated with femoral retroversion, but femoral version was rarely measured. Therefore, mean femoral version, mean femoral neck version, and prevalence of femoral retroversion were analyzed for slipped capital femoral epiphysis patients. METHODS: A retrospective observational study evaluating preoperative hip magnetic resonance imaging of 27 patients (49 hips) was performed. Twenty-seven untreated slipped capital femoral epiphysis patients (28 slipped capital femoral epiphysis hips and 21 contralateral hips, age 10–16 years) were evaluated (79% stable slipped capital femoral epiphysis, 22 patients; 43% severe slipped capital femoral epiphysis, 12 patients). Femoral version was measured using Murphy method on magnetic resonance imaging (January 2014–December 2021, rapid bilateral 3-dimensional T1 water-only Dixon-based images of pelvis and knee). All slipped capital femoral epiphysis patients underwent surgery after magnetic resonance imaging. RESULTS: Mean femoral version of slipped capital femoral epiphysis patients (−1° ± 15°) was significantly (p < 0.001) lower compared to contralateral side (15° ± 14°). Femoral version of slipped capital femoral epiphysis patients had significantly (p < 0.001) wider range from –42° to 35° (range 77°) compared to contralateral side (−5° to 44°, range 49°). Mean femoral neck version of slipped capital femoral epiphysis patients (6° ± 15°) was lower compared to contralateral side (11° ± 12°). Fifteen slipped capital femoral epiphysis patients (54%) had absolute femoral retroversion (femoral version < 0°). Six of the 12 hips (50%) with severe slips and 4 of the 8 hips (50%) with mild slips had absolute femoral retroversion (femoral version < 0°). Ten slipped capital femoral epiphysis patients (40%) had absolute femoral neck retroversion (femoral neck version < 0°). CONCLUSION: Although slipped capital femoral epiphysis patients showed asymmetrically lower femoral version compared to contralateral side, there was a wide range of femoral version, underlining the importance of patient-specific femoral version analysis on preoperative magnetic resonance imaging. Absolute femoral retroversion was prevalent in half of slipped capital femoral epiphysis patients, in half of severe slipped capital femoral epiphysis patients, and in half of mild slipped capital femoral epiphysis patients. This has implications for anterior hip impingement and for surgical treatment with in situ pinning or femoral osteotomy (e.g. proximal femoral derotation osteotomy) or other hip preservation surgery. SAGE Publications 2023-02-03 /pmc/articles/PMC10080244/ /pubmed/37034201 http://dx.doi.org/10.1177/18632521221149044 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by-nc/4.0/This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
spellingShingle Hip disorders
Lerch, Till D
Kaim, Tilman
Hanke, Markus S
Schmaranzer, Florian
Steppacher, Simon D
Busch, Jasmin D
Novais, Eduardo N
Ziebarth, Kai
Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title_full Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title_fullStr Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title_full_unstemmed Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title_short Assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: Theoretical implications for hip impingement risk estimation
title_sort assessment of femoral retroversion on preoperative hip magnetic resonance imaging in patients with slipped capital femoral epiphysis: theoretical implications for hip impingement risk estimation
topic Hip disorders
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10080244/
https://www.ncbi.nlm.nih.gov/pubmed/37034201
http://dx.doi.org/10.1177/18632521221149044
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