Anteversion and retroversion describe opposite deviations in the relationship between the femoral neck axis and the distal femoral condylar axis. Changing this relationship alters how the proximal and distal femur orient relative to one another. That rotational mismatch can therefore affect hip and knee mechanics, rather than representing an isolated anatomical measurement.
Rotational changes can alter the orientation of the hip and knee joints, which may affect the path of the patella during knee movement and the mechanics of the limb during walking. These effects explain why rotational alignment has functional importance beyond bone position alone and why abnormal anteversion or retroversion may be associated with altered gait.
Evaluation focuses particularly on the femoral neck axis and the distal femoral condylar axis. Their angular relationship provides a basis for identifying rotational orientation and recognizing possible torsional deformity. Physical examination can contribute clinical information, while imaging may be used when a more detailed assessment of the osseous relationship is needed.
Assessment combines physical examination with imaging when necessary. Examination provides a clinical evaluation of limb rotation and function, while imaging allows comparison of relevant femoral reference axes. Together, these approaches help determine whether abnormal anteversion or retroversion is present and support interpretation of its possible effects on joint orientation and gait.
Rotational alignment becomes important when surgery must restore or preserve the femur’s intended orientation. In corrective osteotomy, the assessment helps guide correction of a torsional deformity. During fracture fixation, it supports alignment decisions so that the repaired femur does not retain a rotational mismatch that could compromise hip or knee mechanics.
In hip or knee arthroplasty, accurate restoration of femoral rotational alignment helps reestablish appropriate joint orientation and limb biomechanics. Assessment of the relevant axes can guide surgical planning and alignment decisions. Restoring this relationship may improve mechanical function and reduce complications associated with persistent rotational malalignment.