FP4.4 Concomitant Arthroscopic Labral Repair or Reconstruction of the Hip Staged with Femoral Derotational Osteotomy in Patients with Labral Tear and Femoral Malversion Yields Favorable Outcomes

Abstract

Abstract ICLA04 - The Labral Repair Blueprint: Mastering Anchorage, Suture Loops, and Everyday Success, Auditorium B (BMCC Level 1), October 8, 2026, 10:30 - 12:30 Purpose To evaluate clinical and patient-reported outcomes measures (PROMs) following concomitant arthroscopic labral repair or reconstruction with femoral derotational osteotomy (FDRO) in patients with symptomatic femoral malversion. A secondary objective was to assess version-specific outcomes in excessive anteversion and retroversion subgroups. Methods A retrospective case series was conducted at a high-volume academic hip preservation center. Adult patients who underwent FDRO with concomitant labral repair/reconstruction between 2018 and 2024 were identified. Excessive femoral anteversion was defined as femoral version ≥27°, and retroversion as ≤0° on preoperative computed tomography (CT). Radiographic parameters, hip range of motion (ROM), and PROMs (Non-Arthritic Hip Score [NAHS], modified Harris Hip Score [mHHS]) were collected preoperatively and at a minimum one-year follow-up. Kaplan–Meier analysis assessed failure-free survivorship. An anchor-based assessment of whether each operated hip felt “completely better” postoperatively was recorded. Results Ten patients (13 hips) were included (mean age, 27.0 ± 5.0 years; mean follow-up, 3.1 ± 2.5 years). Nine hips (69.2%) demonstrated excessive anteversion and four (30.8%) excessive retroversion. Significant improvements in PROMs were observed, with NAHS improving from 60.8 ± 10.9 to 90.5 ± 12.6 and mHHS from 53.5 ± 7.9 to 87.9 ± 10.4 (both p < 0.001). In the anteversion subgroup, internal rotation decreased, and external rotation increased significantly (p < 0.001), with 55.6% reporting complete recovery. In the retroversion subgroup, reciprocal changes in rotational ROM and improvements in mHHS were observed, with 75.0% reporting complete recovery. Kaplan–Meier analysis showed 100% failure-free survival. Conclusion Combined FDRO and hip arthroscopy result in significant improvements in PROMs and hip rotation. Both excessive anteversion and retroversion demonstrated consistent clinical benefit, supporting the importance of addressing femoral version abnormalities in hip preservation surgery.