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Prevalence and diagnostic accuracy of in-toeing and out-toeing of the foot for patients with abnormal femoral torsion and femoroacetabular impingement: Implications for hip arthroscopy and femoral derotation osteotomy

The Bone & Joint Journal Oct 11, 2019

Lerch TD, Eichelberger P, Baur H, et al. - In the gait laboratory, a retrospective, institutional review board-approved, controlled study of 85 symptomatic individuals (148 hips) with femoroacetabular impingement (FAI) or hip dysplasia was conducted in order to ascertain the prevalence and diagnostic exactness of in-toeing to identify increased femoral torsion (FT), whether foot progression angle (FPA) and tibial torsion were distinctive among individuals with abnormal FT, and whether FPA associated with FT. High specificity and the positive predictive value to identify increased FT was seen in the in-toeing, however, due to the low sensitivity and high false-negative rate, raised FT could be missed. Hence, in individuals with FAI or hip dysplasia undergoing hip arthroscopy or femoral derotation osteotomy, these outcomes could be employed for the diagnosis of abnormal FT. Nevertheless, most of the individuals with enhanced FT walked with a normal foot position. Moreover, this could result in underestimation or wrongly diagnosed abnormal FT. Thus, in all individuals with FAI, measuring FT with CT/MRI scans was suggestive.
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