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. (Request a copy)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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