Highlights
- •Hip internal rotation range of motion is maximized in anteverted hip patients.
- •Hip external rotation range of motion is maximized in retroverted hip patients.
- •Femoral version abnormalities affected hip muscle strength.
- •Rotation index is a strong femoral version predictor.
- •Femoral version should be considered in decision making of patients with hip pain.
Abstract
Background
A high prevalence of femoral version abnormalities has been observed in hip pain patients,
with impact on hip range of motion and muscle strength that should be elucidated.
Methods
Cross-sectional study. Thirty-one patients with hip pain (16 men and 15 female) were
subjected to Biplanar X-Rays to quantify femoral version using three-dimensional measurements.
The 62 hips were divided into normal version (10–20°, n = 18), anteverted (>20°, n = 19), and retroverted (<10°, n = 25). Joint range of motion for flexion, internal rotation, and external rotation
was assessed through digital goniometry. Maximal isometric hip strength (flexion,
extension, internal rotation, external rotation at 0° and 30°, abduction, adduction)
was evaluated through hand-held dynamometry. Hip rotation index was calculated as
external rotation minus internal rotation.
Findings
Anteverted hips had greater internal rotation, while retroverted hips had greater
external rotation (p = 0.001). Anteverted hips were weaker than retroverted hips for external rotation
at 30° (p < 0.001), abduction (p = 0.006) and adduction (p < 0.001), and weaker than normal version hips for extension (p = 0.018). All three groups had different rotation index: retroverted>normal>anteverted
(p < 0.001). The ordinal logistic regression found higher values of rotation index with
higher probability of being retroverted (common odds ratio = 1.20). There was a strong
correlation between femoral version group and rotation index (rS = 0.76, p < 0.001). There was probability >70% of a hip being anteverted if the rotation index
was <11°, and being retroverted if the index was >40°.
Interpretation
Range of motion and muscle strength differed in hips with different femoral versions.
The hip rotation index was a strong femoral version predictor.
Keywords
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Article info
Publication history
Published online: June 17, 2022
Accepted:
June 14,
2022
Received:
June 14,
2021
Identification
Copyright
© 2022 Elsevier Ltd. All rights reserved.
