FP5.8 Effect of Femoral Version on Hip Impingement Volume: A Quantitative Analysis

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ID: 331195
2026
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Abstract
Abstract ICLB05 - The Art of Navigation: Foundations of Efficient and Complication-Free Hip Arthroscopy, Session Room 6 (BMCC Level 3), October 8, 2026, 14:00 - 16:00 Introduction Femoroacetabular impingement (FAI) is a leading cause of hip pain and early osteoarthritis in young active patients. Accurate preoperative planning is essential to select the optimal surgical correction and avoid under- or over-correction. The purpose of this study was to quantify the effect of increasing femoral version on hip impingement volume and to determine whether acetabular morphology or acetabular version predicts the magnitude of this reduction. Methods Twenty-one hips were included. Impingement volume (IV) was quantified at femoral version of 0°, 12°, and 25° and after hip kinematic analysis to 90° flexion, 30° internal rotation and 30° adduction. Anatomical parameters (LCE, ACI, ACE, acetabular version) were measured for each hip. The Friedman test assessed differences across the three time points, with post-hoc Wilcoxon signed-rank tests and Bonferroni correction. Spearman correlation evaluated associations between delta IV (ΔIV) and anatomical parameters. Results Increasing femoral version produced a progressive and significant reduction in IV. Median IV decreased from 2629 mm3 at 0° to 1041 mm3 at 12° and 269 mm3 at 25°. The Friedman test confirmed an overall significant difference (χ2 = 42.0, p < 0.001). All pairwise comparisons were statistically significant after Bonferroni correction (p < 0.001 for all). In 3/21 cases, no impingement was observed at 25° of femoral version despite clear asphericity of the femoral head. ACE was strongly correlated with ΔIV at both 12° (ρ = 0.751, p < 0.001) and 25° (ρ = 0.784, p < 0.001), indicating that greater antero-lateral acetabular coverage predicts a larger IV reduction. ACI showed a borderline negative correlation with ΔIV at 25° (ρ = −0.460, p = 0.047). LCE was not significantly associated with ΔIV (p > 0.15). Acetabular version (median 14.9°, range 6.1°–25.2°) was not significantly correlated with ΔIV at any measurement point (p ≥ 0.095), although a non-significant negative trend was observed. Conclusion Increasing femoral version significantly and progressively reduces hip impingement volume. ACE is the strongest predictor of the magnitude of this reduction, highlighting the role of acetabular morphology in determining the benefit of arthroscopic or open femoral osteoplasty or even femoral derotation osteotomy. Acetabular version did not independently predict IV reduction. These findings may support more individualised surgical planning in femoroacetabular impingement.
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Authors Klemen Stražar, Aljoša Korošec, Andraž Kraševec, Borut Kovačić
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Journal Journal of hip preservation surgery
Year 2026
DOI
10.1093/jhps/hnag043.040
URL
https://doi.org/10.1093/jhps/hnag043.040
Keywords Keywords not found

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