Editorial Commentary: Femoral Version Is Not a Solo Act but Rather a Complex Interplay When Considered in Hip Preservation

Femoral retroversion is increasingly recognized as a contributor to hip pain, impingement, and inferior outcomes after hip preservation surgery. Although its natural history remains incompletely defined, biomechanical studies show that retroversion decreases impingement-free range of motion and alters labral contact. Clinical outcomes following hip arthroscopy in retroverted hips have been mixed. Recent comparative studies have reported that femoral derotational osteotomy, either alone or combined with hip arthroscopy, can outperform hip arthroscopy alone in terms of patient-reported outcomes in patients with <5° of femoral anteversion.