TY - JOUR
T1 - Abnormal Femoral Anteversion Is Associated With the Development of Hip Osteoarthritis
T2 - A Systematic Review and Meta-Analysis
AU - Parker, Emily A.
AU - Meyer, Alex M.
AU - Nasir, Momin
AU - Willey, Michael C.
AU - Brown, Timothy S.
AU - Westermann, Robert W.
N1 - Funding Information:
The authors report the following potential conflicts of interest or sources of funding: M.C.W. reports personal fees from DePuy Synthes Sales; other from Smith & Nephew; and personal fees from Zimmer Biomet and Stryker, outside the submitted work. R.W.W. reports personal fees, nonfinancial support, and other from Smith & Nephew; other from Arthrex; personal fees from Medical Device Business Systems; personal fees from Linvatec; and other from Wardlow Enterprises, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Publisher Copyright:
© 2021 Arthroscopy Association of North America. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
PY - 2021/12
Y1 - 2021/12
N2 - Purpose: To perform a systematic review and meta-analysis of literature and to evaluate the relationship between abnormal femoral version and the development of hip osteoarthritis (OA). Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, evaluating Level I and II studies. Included studies had to provide granular femoral version (FV) information. The severity of OA was ranked on the Kellgren–Lawrence (KL) scale. Excel version 1808 (Microsoft, Redmond, WA) was used to perform a student t test statistical analyses. Results: Our review identified 19 qualifying studies—5 Level I and 14 Level II with 1,756 patients. Patients with FV above normal range (>14°) had greater KL scores than patients with normal range FV (mean ± standard deviation; 3.37 ± 1.44 vs 2.05 ± 1.72, P < .05). Analysis of KL scores in patients with FV >24° (>1 standard deviation) versus patients with FV >14° but <24° also demonstrated a positive correlation between increasing FV and KL (4.00 ± 1.96 vs 2.34 ± 0). This was significant independent of the presence or absence of developmental dysplasia of the hip. Retroverted hips (FV<10°) in the present study showed variable OA results upon analysis. Conclusions: The present review suggests that elevated FV may be a risk factor for more severe hip OA with or without the presence of concurrent dysplasia of the hip. The relative amount of increased anteversion appears positively correlated with severity of OA. Although femoral retroversion may impact hip mechanics, in this review it does not appear to strongly correlate with the development of OA. Level of Evidence: II: systematic review of Level I and II studies.
AB - Purpose: To perform a systematic review and meta-analysis of literature and to evaluate the relationship between abnormal femoral version and the development of hip osteoarthritis (OA). Methods: A systematic review was performed following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, evaluating Level I and II studies. Included studies had to provide granular femoral version (FV) information. The severity of OA was ranked on the Kellgren–Lawrence (KL) scale. Excel version 1808 (Microsoft, Redmond, WA) was used to perform a student t test statistical analyses. Results: Our review identified 19 qualifying studies—5 Level I and 14 Level II with 1,756 patients. Patients with FV above normal range (>14°) had greater KL scores than patients with normal range FV (mean ± standard deviation; 3.37 ± 1.44 vs 2.05 ± 1.72, P < .05). Analysis of KL scores in patients with FV >24° (>1 standard deviation) versus patients with FV >14° but <24° also demonstrated a positive correlation between increasing FV and KL (4.00 ± 1.96 vs 2.34 ± 0). This was significant independent of the presence or absence of developmental dysplasia of the hip. Retroverted hips (FV<10°) in the present study showed variable OA results upon analysis. Conclusions: The present review suggests that elevated FV may be a risk factor for more severe hip OA with or without the presence of concurrent dysplasia of the hip. The relative amount of increased anteversion appears positively correlated with severity of OA. Although femoral retroversion may impact hip mechanics, in this review it does not appear to strongly correlate with the development of OA. Level of Evidence: II: systematic review of Level I and II studies.
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U2 - 10.1016/j.asmr.2021.07.029
DO - 10.1016/j.asmr.2021.07.029
M3 - Review article
AN - SCOPUS:85120703199
SN - 2666-061X
VL - 3
SP - e2047-e2058
JO - Arthroscopy, Sports Medicine, and Rehabilitation
JF - Arthroscopy, Sports Medicine, and Rehabilitation
IS - 6
ER -