Impingement Syndrome

Deep gluteal syndrome (DGS) is a significant cause of posterior hip pain resulting from the compression of the sciatic or other peripheral nerves in the deep gluteal space. Understanding the anatomy of the deep gluteal space and the kinematics of the sciatic nerve, as it passes through this region is crucial for understanding DGS. Despite increasing awareness, DGS is still often overlooked. This review focuses on conditions that specifically contribute to posterior hip pain as a consequence of DGS. Predominantly addressing piriformis syndrome, gemelli-obturator internus syndrome, ischiofemoral impingement syndrome, and proximal hamstring syndrome, the review also touches upon rare cases such as inferior and superior gluteal nerve entrapment...

BACKGROUND: Subacromial spurs are considered the one of the pathology underlying shoulder impingement syndrome. Furthermore, few studies have focused on the morphology of the subacromial spurs in normal Chinese people. This study aimed to study the spur distribution and to illustrate the morphology of spurs, which may help guide the extent of acromioplasty. METHODS: A total of 93 normal individuals were enrolled, and both shoulders of all enrolled individuals were analyzed...

BACKGROUND: The effects of specific bony hip morphologies, cam and dysplasia, and cartilage damage on mid- and long-term (≥5 years) patient-reported outcomes (PROs) are understudied. PURPOSE: To investigate if changes in PROs from preoperatively to 5 years after hip arthroscopy are associated with preoperative bony hip morphology and cartilage status in patients with femoroacetabular impingement syndrome. STUDY DESIGN: Cohort study; Level of evidence, 3...

BACKGROUND: Subacromial pain syndrome (SPS) is the most common cause of shoulder pain. Therapeutic exercise is the first-line treatment for SPS; however, the ideal exercise type remains unclear. Here, we compared the effects of eccentric and concentric strengthening in patients with SPS. HYPOTHESIS: Adding isolated eccentric strengthening to a multimodal physiotherapy program (MPP) would lead to greater improvements in outcomes compared with either MPP alone or adding isolated concentric strengthening to the MPP...

PURPOSE: To compare pre- and post-operative findings between patients undergoing hip arthroscopy for femoroacetabular impingement syndrome (FAIS) with lateral impingement versus those without lateral impingement METHODS: Patients who underwent primary hip arthroscopy for FAIS between 2012-2017 with minimum 5-year follow-up were included. Alpha angle (AA) was measured on preoperative AP and 90° Dunn radiographs. Patients with AA > 60° on Dunn view but not AP view (no lateral impingement) were propensity matched by sex, age, and BMI in a 1:3 ratio to patients with AA > 60° on both views (lateral impingement)...

OBJECTIVE: To compare clinical assessment findings between elite athletic populations with and without a clinical diagnosis of posterior ankle impingement syndrome (PAIS). DESIGN: Cross-sectional case-control study. SETTING: Elite ballet and sport. PARTICIPANTS: Ten male and female professional ballet dancers and athletes with a clinical diagnosis of PAIS and were matched for age, sex, and activity to 10 professional ballet dancers and athletes without PAIS...

BACKGROUND: Cervical transforaminal epidural steroid injections have become less popular due to the risk of catastrophic complications they pose. However, cervical nerve root blocks are useful for surgical planning in patients with cervical radicular pain syndromes. OBJECTIVES: Our aim was to find a method of performing cervical selective nerve root blocks that removed the risk of catastrophic complications. STUDY DESIGN: Retrospective case review...

Isolated lateral-sided knee pain is a unique problem following total knee arthroplasty (TKA). Reported causes include soft tissue impingement against extruded cement, an overhanging tibial tray, remnant osteophytes rubbing against the iliotibial band (ITB), popliteal tendon impingement, fabella syndrome, and synovial tissue impingement in the lateral gutter. In addition, iliotibial band traction syndrome secondary to guided motion Bi-cruciate stabilizing knee arthroplasty has been recognized as a new clinical entity...

BACKGROUND: Emerging evidence has indicated the associations between subacromial impingement syndrome (SIS) of shoulder and lifestyle factors. However, whether unhealthy lifestyle factors causally increase SIS risk is not determined. This study aims to evaluate whether lifestyle factors are the risk factors of SIS. METHODS: A two-sample Mendelian randomization (MR) study was designed to evaluate the effect of 11 lifestyle factors on SIS risk. Causality was determined using the inverse-variance weighted method to calculate the odds ratio (OR) and establish a 95% confidence interval (CI)...

Hip capsular preservation literature shows varying outcome. Capsular preservation is most common in the United States. Different surgeons prefer, and different patients require simple periportal capsulotomies versus wider exposure with T-type capsulotomy and traction stitches. Revision cases require wider expose. Paramount is adequate bony decompression in patients with FAI, but capsular preservation may also be universally recommended. Finally, in addition to revision indications, some hip phenotypes may require more aggressive capsular management...

OBJECTIVE: To evaluate the effectiveness of scapular stabilization exercises (SSE) in the treatment of subacromial pain syndrome (SAPS). METHODS: Clinical randomized controlled trials (RCTs) on SSE in the treatment of SAPS were searched electronically in PubMed, Science Direct, Cochrane Central Register of Controlled Trials (CENTRAL), EBSCOhost, Physiotherapy Evidence Database (PEDro), Web of Science, and other databases from 2000 to 2022, supplemented by manual search...

PURPOSE: To evaluate clinical depression scores and functional outcomes following arthroscopic treatment of femoroacetabular impingement syndrome in patients with elevated preoperative depressive symptoms as defined by Patient-Reported Outcomes Measurement Information System for Depression (PROMIS-D). METHODS: Patients with femoroacetabular impingement syndrome completed the PROMIS-D Computer Adaptive Test and additional patient-reported outcome (PRO) measures preoperatively and at the time of postoperative visits...

Determining the appropriate femoral cam resection during hip arthroscopy for femoroacetabular impingement syndrome is both critical for the patient and challenging for the surgeon. Incomplete bone resection is a leading cause of failed hip arthroscopy, whereas over-resection may increase the risk of femoral neck fracture. The alpha angle is a validated 2-dimensional radiographic measurement used to both diagnose femoroacetabular impingement syndrome preoperatively and to determine resection adequacy postoperatively...

INTRODUCTION: Ulnocarpal impaction syndrome causes pain on the ulnar side of the wrist. Various surgical techniques have been described. Ulnar shortening osteotomy is now a standard treatment. However, it is associated with complications such as non-union of the osteotomy site. The main study objective was to report the rate of radiographic consolidation after ulnar shortening osteotomy with a cutting guide. MATERIAL AND METHODS: This multicenter retrospective study of 30 cases reported clinical and radiographic criteria at a minimum 6 month's follow-up...

OBJECTIVES: This study aimed to ascertain the prevalence of cam Femoroacetabular Impingement Syndrome (cam-FAIS) in Anterior knee pain (AKP) patients devoid of both structural patellofemoral joint (PFJ) abnormalities and lower limb skeletal mal-alignment. A secondary objective was to examine pain and disability differences between AKP patients with and without cam-FAIS. METHODS: A total of 209 AKP patients were screened for eligibility. Inclusion criteria were normal imaging studies and normal lower limb alignment, and exclusion criteria were previous knee surgery and knee and/or hip osteoarthritis...

Anterior ankle impingement syndrome (AAIS) has been reported to account for a high percentage of complications following ankle fracture surgery. The soft tissue etiology of AAIS is thought to be thickening and inflammation of the anterior ankle soft tissues intervening anteriorly at the tibiotalar joint, causing pain and functional limitation during dorsiflexion. However, the effects of anterior ankle soft tissue dynamics and stiffness on AAIS have yet to be clarified. This study aimed to determine the relationship between AAIS and the anterior ankle soft tissue thickness change ratio and shear modulus using ultrasonography (US)...

BACKGROUND: Little is known about the effect of modern hip arthroscopy on the natural history of femoroacetabular impingement syndrome (FAIS) with respect to joint preservation. PURPOSE: To (1) characterize the natural history of FAIS and (2) understand the effect of modern hip arthroscopy by radiographically comparing the hips of patients who underwent only unilateral primary hip arthroscopy with a minimum follow-up of 10 years. STUDY DESIGN: Cohort study; Level of evidence, 3...

INTRODUCTION: In recent years, the utilization of hip arthroscopy to treat femoroacetabular impingement syndrome (FAIS) has increased due to its low complication rates, positive impact on patient-reported outcomes (PROs), and association with faster rehabilitation. Despite this, there are high rates of revision and conversion to total hip arthroplasty (THA) in some of these patients. It is unclear whether time from initial FAIS diagnosis to surgery is a risk factor for poor outcomes. In this study, we examined the relationship between timing of hip arthroscopy for FAIS and rates of 2-year revision hip procedures, 2-year conversion to total hip arthroplasty (THA), post-operative medical complications, and opioid prescriptions...

Gluteal pain is a frequent cause of medical attention in the daily clinical practice. It can be caused by multiple pathologies, being ischiofemoral impingement syndrome among those included in its differential diagnosis. Encompassed within the deep gluteal syndromes, this entity occurs as a consequence of the entrapment of the neuromuscular structures between the lesser femoral trochanter and the ischial tuberosity, causing pain in the root of the lower limb, with irradiation towards the thigh or the gluteal region and poor tolerance to deambulation and sedestation...

INTRODUCTION AND IMPORTANCE: Dural ectasia, which is often idiopathic, is seen both in patients with neurofibromatosis and Marfan's syndrome. In neurofibromatosis, the ectasia is most often seen in the thoracic region but can occur at any point along the dura. A complication such as cauda equina syndrome is usually rare. CLINICAL PRESENTATION: A 48 year old male complaining of recurrent throbbing headache, for 3 years, 2 years ago he developed progressively lower back pain, associated with numbness and tingling sensation of the lower limbs...