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Purpose: To determine the association between femoral torsion and anterior cruciate ligament (ACL) rupture and determine the level of torsion using magnetic resonance imaging (MRI). Methods: The medical records of patients who were diagnosed with ACL injury were reviewed retrospectively. This descriptive epidemiological study included 2344 patients. MRI scans were examined and patients with femur and knee MRI scans obtained at the same time were identified (ACL-deficient group). Twenty-eight of them had femur and knee MRI scans because of an incidental benign lesion in the distal femur. Patients who were diagnosed with enchondroma were followed up by MRI evaluation of the femur and were randomly selected as controls. Supratrochanteric torsion (STT), infratrochanteric torsion (ITT), and femoral anteversion (FA) were measured by orthopedic surgeons with at least 5 years of experience. Results: Age, sex, and side properties were similar in both groups. The mean FA values were 19.4 ± 3.0 degrees and 11.9 ± 2.0 degrees in the ACL-deficient and control groups, respectively (p < 0.001). STT was similar in the ACL-deficient and control groups [mean: 38.2 ± 4.3 and 37.7 ± 3.3, respectively, (n.s.)]. ITT was increased in the ACL-deficient group compared with the control group (mean − 18.8 ± 4.3 and − 25.8 ± 3.8, respectively; p < 0.001). Conclusions: According to our results, increased FA was associated with ACL rupture. Further, the torsional abnormality was developed from the ITT. We concluded that each ACL-deficient patient should be assessed by a clinician for torsional abnormality using physical examination. Level of evidence: III [ABSTRACT FROM AUTHOR]

Background: Adductor tenotomy is needed for clinically complex hips with soft-tissue contractures. It may be proposed that the patients who need adductor tenotomy during closed reduction would have poorer prognosis than the ones without need for adductor tenotomy. The main purposes were to compare the normalization of acetabular index angle (AI), to determine the incidence of femoral head avascular necrosis (AVN), and to predict the need for any secondary surgical intervention between the patients who need adductor tenotomy and those who do not during closed reduction for developmental dysplasia of the hip. Materials and Methods: The study group consisted of 65 hips treated between 6 and 12 months of age. The mean age at the time of surgery was 8.1 ± 1.4 (6–12) months and the mean follow-up was 4.2 ± 1.5 years. Improvement of AI, rate and severity of AVN, and need for secondary surgery with its predictors were evaluated. Results: Adductor tenotomy was performed in 22 hips (Group 1), but not in 43 hips (Group 2). Normalization of the AI was − 14.8° ± 3.5° versus − 14.3° ± 3.2°. The overall incidence of AVN was 18.4%. The rate of secondary surgical intervention was higher in Group 1 (63.1% versus 36.9%) (p = 0.014). Conclusions: No significant difference was detected regarding the improvement of AI as well as the incidence of AVN between the groups. The need for adductor tenotomy during closed reduction was one of the main predictors of the possible secondary surgery. [ABSTRACT FROM AUTHOR]