Boschung, Adam; Faulhaber, Senta; Kiapour, Ata; Kim, Young-Jo; Novais, Eduardo N; Steppacher, Simon D; Tannast, Moritz; Lerch, Till D (2023). Femoral impingement in maximal hip flexion is anterior-inferior distal to the cam deformity in femoroacetabular impingement patients with femoral retroversion : implications for hip arthroscopy. Bone & joint research, 12(1), pp. 22-32. British Editorial Society of Bone & Joint Surgery 10.1302/2046-3758.121.BJR-2022-0263.R1
Full text not available from this repository.AIMS
Femoroacetabular impingement (FAI) patients report exacerbation of hip pain in deep flexion. However, the exact impingement location in deep flexion is unknown. The aim was to investigate impingement-free maximal flexion, impingement location, and if cam deformity causes hip impingement in flexion in FAI patients.
METHODS
A retrospective study involving 24 patients (37 hips) with FAI and femoral retroversion (femoral version (FV) < 5° per Murphy method) was performed. All patients were symptomatic (mean age 28 years (SD 9)) and had anterior hip/groin pain and a positive anterior impingement test. Cam- and pincer-type subgroups were analyzed. Patients were compared to an asymptomatic control group (26 hips). All patients underwent pelvic CT scans to generate personalized CT-based 3D models and validated software for patient-specific impingement simulation (equidistant method).
RESULTS
Mean impingement-free flexion of patients with mixed-type FAI (110° (SD 8°)) and patients with pincer-type FAI (112° (SD 8°)) was significantly (p < 0.001) lower compared to the control group (125° (SD 13°)). The frequency of extra-articular subspine impingement was significantly (p < 0.001) increased in patients with pincer-type FAI (57%) compared to cam-type FAI (22%) in 125° flexion. Bony impingement in maximal flexion was located anterior-inferior at femoral four and five o'clock position in patients with cam-type FAI (63% (10 of 16 hips) and 37% (6 of 10 hips)), and did not involve the cam deformity. The cam deformity did not cause impingement in maximal flexion.
CONCLUSION
Femoral impingement in maximal flexion was located anterior-inferior distal to the cam deformity. This differs to previous studies, a finding which could be important for FAI patients in order to avoid exacerbation of hip pain in deep flexion (e.g. during squats) and for hip arthroscopy (hip-preservation surgery) for planning of bone resection. Hip impingement in flexion has implications for daily activities (e.g. putting on shoes), sports, and sex.Cite this article: Bone Joint Res 2023;12(1):22-32.
Item Type: |
Journal Article (Original Article) |
|---|---|
Division/Institute: |
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic, Interventional and Paediatric Radiology 04 Faculty of Medicine > Department of Orthopaedic, Plastic and Hand Surgery (DOPH) > Clinic of Orthopaedic Surgery |
UniBE Contributor: |
Steppacher, Simon Damian, Lerch, Till |
Subjects: |
600 Technology > 610 Medicine & health |
ISSN: |
2046-3758 |
Publisher: |
British Editorial Society of Bone & Joint Surgery |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
11 Jan 2023 06:55 |
Last Modified: |
11 Jan 2023 23:23 |
Publisher DOI: |
10.1302/2046-3758.121.BJR-2022-0263.R1 |
PubMed ID: |
36620909 |
Uncontrolled Keywords: |
CT scans Extra-articular hip impingement FAI Femoroacetabular impingement Hip arthroscopy Hip preservation surgery Subspine impingement cam deformities cam-type femoroacetabular impingement femoral retroversion femoroacetabular impingement flexion hip arthroscopy hip flexion hip pain hips |
URI: |
https://boris.unibe.ch/id/eprint/177137 |
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