EP1.17 The prevalence of malrotation and corrective osteotomy surgery in young adults presenting with hip pain. Severe tibial torsion is a strong predictor for osteotomy in malrotation related hip pain

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ID: 331165
2026
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Abstract
Abstract Objectives Femoral version (FV) abnormalities are frequent in adults presenting with hip pain however tibial torsion (TT) abnormalities can also cause hip pain. This study aimed to quantify the prevalence of lower limb rotational abnormalities and identify any predicting factors for corrective osteotomy. Methods Retrospective analysis of 117 patients (149 symptomatic lower limbs) presenting with hip pain to a young adult hip clinic between June 2020 and December 2024. Measurements of FV and TT used the Murphy and Kristiansen techniques with CT rotational profile scans. Severely and moderately decreased, normal and moderately and severely increased FV were classified as the following angles: <0o, 0-9o, 10-25o, 26-35o and >36o. Normal, moderate and severely increased TT were classified as 0-40o, 41-50o and >50o. Results The mean age was 25.7 (SD 9.7) with 70.3% females. Mean FV was 25.3o degrees (SD 14.3) and mean TT was 43.4o (SD 9.5). 57.7% patients had symptomatic malrotation on the right. 42% of patients underwent osteotomies for symptomatic malrotation syndrome. 82% of those undergoing osteotomy were female. Females made up 86.6% and 60.6% of severely increased femoral anteversion and TT categories respectively. Normal, moderate and severely increased FV was present in 43.0%, 24.8% and 20.1% respectively, with moderate and severely decreased FV present in 10.7% and 1.3%. Normal, moderate and severely increased TT was present in 38.9%, 38.9% and 22.1%. Multi-variable regression showed adjusted odds ratio (aOR) of 7.77 (95% CI 2.71-22.3; p<0.001) for patients with severe TT requiring osteotomy for hip pain symptoms. Moderately increased TT (aOR 1.92 p=0.129), moderately and severely increased femoral anteversion (aOR 1.12 p=0.809, aOR 1.23 p=0.695) and moderately and severely decreased femoral anteversion (aOR 0.99, p=0.989) were not significantly associated with osteotomy. A pearson correlation of 0.306 was identified between increased TT and increased FV (p<0.001). Conclusions The majority of patients with symptomatic malrotation were women. A predictive correlation was identified between increased tibial torsion and increased femoral version. The majority of patients undergoing osteotomy for malrotation related hip pain were female. Severe tibial torsion was the only significant predictor of needing osteotomy for malrotation causing hip pain.
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Authors Sefa William Canbilen, Tony Andrade, Daniel Chien
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.201
URL
https://doi.org/10.1093/jhps/hnag043.201
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