Editorial Commentary : Combined Hip Version Abnormalities May Not Negatively Influence Patient Outcomes, Depending How Version Is Measured and Combined Version Is Categorized

Abstract

Hip arthroscopy for femoroacetabular impingement syndrome (FAIS) continues to expand in its indications while showing excellent clinical outcomes. However, reported outcomes in the setting of version abnormalities vary widely across the literature. Historically, femoral and acetabular retroversion have been associated with inferior results, yet more recent studies suggest that a broader range of version morphologies may be successfully treated arthroscopically. A key limitation in the literature is the lack of standardization in measuring and defining version. Multiple techniques exist for assessing femoral version, with substantial variability between methods. Similarly, acetabular retroversion is often defined using radiographic signs that may not correlate with version measured on advanced imaging. Further complicating interpretation, several approaches to categorizing combined version exist, including the McKibbin index, numerical summation, and modified classification systems such as that used in the current study. As evidence emerges suggesting that combined version abnormalities may not significantly influence postoperative outcomes following hip arthroscopy, it is essential to consider how version is measured and how morphology is classified. Until standardized, reproducible methods are established, comparisons across studies will remain limited, and conclusions regarding the true impact of version on outcomes should be interpreted with caution.