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hip and impingement

Jun Han, Seok-Hyung Won, Jung-Taek Kim, Myung-Hoon Hahn, Ye-Yeon Won
Purpose: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems...
March 2018: Hip & Pelvis
Seung Min Choi, Myung Sik Park, Bareun Chan Ju, Sun Jung Yoon
INTRODUCTION: The restoration of range of motion after surgery in patients with femoroacetabular impingement syndrome is considered an important factor that improves clinical outcomes and determines the quality of life of patients, especially in the Asian population. METHODS: Arthroscopic femoroplasty was done in 109 Asian patients with cam impingement. The patients were retrospectively evaluated using range of motion and clinical outcomes (Harris Hip Score [HHS], visual analog scale score, Hip Outcome Score-Activity of Daily Living, and Hip Outcome Score-Sports subscales) between preoperative and postoperative conditions, with a follow-up period of >2 years...
March 19, 2018: Journal of the American Academy of Orthopaedic Surgeons
Robert J Cooper, Sophie Williams, Marlène Mengoni, Alison C Jones
BACKGROUND: Impingement resulting in soft tissue damage has been observed in hips with abnormal morphologies. Geometric parameterisation can be used to automatically generate a range of bone geometries for use in computational models, including femurs with cam deformity on the femoral neck. METHODS: This study verified patient-specific parametric finite element models of 20 patients with cam deformity (10 female, 10 male) through comparison to their patient-specific segmentation-based equivalents...
March 14, 2018: Clinical Biomechanics
Victor Ortiz-Declet, Brian Mu, Austin W Chen, Jody Litrenta, Leslie C Yuen, Stephanie M Rabe, Benjamin G Domb
Arthroscopic acetabuloplasty involves trimming of bone from the acetabular rim. Although early techniques often involved detachment of the labrum prior to bone resection, recent studies have reported on acetabuloplasty without labral detachment. This method has the benefit of preserving the labro-osseous junction, but visualization of the acetabular rim may be more difficult. Compromised visualization can lead to incomplete resection and residual impingement. We describe an arthroscopic perspective called the "bird's eye" and "upper deck" views that facilitates optimal visualization of the acetabuloplasty without labral detachment...
January 2018: Arthroscopy Techniques
Assem A Sultan, Anton Khlopas, Inyang Udo-Inyang, Morad Chughtai, Nipun Sodhi, Suela Lamaj, Roland Starr, Nicolas S Piuzzi, Anil Bhave, Michael A Mont
INTRODUCTION: Changes in pelvic position has been shown to affect acetabular coverage of the femoral head in total hip arthroplasty (THA) and may contribute to complications such as impingement, dislocation, or early wear. Understanding the kinematic changes of these positions during functional activities may help surgeons reach a consensus regarding stable hip mechanics and ideal implant positioning in THA. Therefore, in this study, we aimed to evaluate the following in patients who had unilateral hip OA: 1) dynamic changes; and 2) variability; in the following pelvic position parameters: A) tilt; B) obliquity; and C) rotation standing position to walking...
March 16, 2018: Surgical Technology International
Nicola C Casartelli, Nicola A Maffiuletti, Romana Brunner, Marcel Büchi, Reto Sutter, Christian W Pfirrmann, Florian D Naal, Michael Leunig, Mario Bizzini
Study Design Cross-sectional study. Background Visual rating of movement pattern in patients with femoroacetabular impingement (FAI) syndrome is of interest because poor control of dynamic hip motion is frequently noted. Objectives To evaluate intra- and inter-rater agreement among physical therapists with different clinical experience, in performing visual rating of movement pattern quality of patients with FAI syndrome using a semiquantitative scale. Methods A video camera was used to record the performance of 34 patients with FAI syndrome performing single-limb standing, squat, frontal lunge, hop lunge, bridge and plank...
March 16, 2018: Journal of Orthopaedic and Sports Physical Therapy
Andrea B Mosler, Rintje Agricola, Kristian Thorborg, Adam Weir, Rod J Whiteley, Kay M Crossley, Per Hӧlmich
Study Design Cross-sectional cohort study. Background Athletes with femoroacetabular impingement (FAI) syndrome have cam and/or pincer morphology, pain on orthopaedic testing, and often have reduced hip range of motion (ROM) and strength. However, cam and pincer morphology are also common in asymptomatic hips. Therefore, it is currently unknown whether the ROM and strength deficits observed in athletes with FAI syndrome result from the variance in their bony hip morphology or hip condition. Objectives To investigate the relationship between musculoskeletal screening findings and bony hip morphology in asymptomatic male soccer players...
March 16, 2018: Journal of Orthopaedic and Sports Physical Therapy
Pim van Klij, Joshua Heerey, Jan H Waarsing, Rintje Agricola
Synopsis Our understanding of femoroacetabular impingement (FAI) syndrome is slowly improving. The number of studies on all aspects (aetiology, prevalence, pathophysiology, natural history, treatment, and preventative measures) of FAI syndrome has grown exponentially over the past few years. This commentary provides the latest updates on the prevalence of cam and pincer hip morphology and its relationship with development of hip osteoarthritis (OA). Cam and pincer morphology is highly prevalent in the general population and in this paper is presented for different subgroups based on: age, sex, ethnicity, and athletic activity...
March 16, 2018: Journal of Orthopaedic and Sports Physical Therapy
G Möckel, W Miehlke
OBJECTIVE: Tenotomy of the psoas tendon in symptomatic internal coxa saltans or psoas impingement should relieve pain. INDICATIONS: Indicated in conservative treatment-resistant internal coxa saltans and in psoas impingement. CONTRAINDICATIONS: Contraindications are symptomatic psoas pathologies in hip dysplasia patients. SURGICAL TECHNIQUE: Three different procedures exist with the arthroscopic technique, in which the psoas tenotomy can be performed at one of three different levels...
March 14, 2018: Operative Orthopädie und Traumatologie
Michael Ryan, Thomas Youm, Jonathan Vigdorchik
Hip arthroscopy as we know it today developed over the last 15 to 20 years, yet its true beginning is far more dated. Initially developed as a means of removing loose bodies or as a means of lavage, hip arthroscopy was not utilized to treat femoroacetabular impingement (FAI) until much later. Its usefulness as a means of treating FAI did not arise until hip impingement was understood to be causal in the development of degenerative changes of the labrum and articular surfaces. As our understanding of FAI grew, the tools for treating it developed in tandem...
March 2018: Bulletin of the Hospital for Joint Diseases
Richard C Mather, Shane J Nho, Andrew Federer, Berna Demiralp, Jennifer Nguyen, Asha Saavoss, Michael J Salata, Marc J Philippon, Asheesh Bedi, Christopher M Larson, J W Thomas Byrd, Lane Koenig
BACKGROUND: The diagnosis and treatment of femoroacetabular impingement (FAI) have increased steadily within the past decade, and research indicates clinically significant improvements after treatment of FAI with hip arthroscopy. PURPOSE: This study examined the societal and economic impact of hip arthroscopy by high-volume surgeons for patients with FAI syndrome aged <50 years with noncontroversial diagnosis and indications for surgery. STUDY DESIGN: Economic and decision analysis; Level of evidence, 2...
March 1, 2018: American Journal of Sports Medicine
William S Murphy, Ho Hyun Yun, Brett Hayden, Jens H Kowal, Stephen B Murphy
BACKGROUND: Cup malposition is a common cause of impingement, limitation of ROM, acceleration of bearing wear, liner fracture, and instability in THA. Previous studies of the safe zone based on plain radiographs have limitations inherent to measuring angles from two-dimensional projections. The current study uses CT to measure component position in stable and unstable hips to assess the presence of a safe zone for cup position in THA. QUESTIONS/PURPOSES: (1) Does acetabular component orientation, when measured on CT, differ in stable components and those revised for recurrent instability? (2) Do CT data support historic safe zone definitions for component orientation in THA? METHODS: We identified 34 hips that had undergone revision of the acetabulum for recurrent instability that also had a CT scan of the pelvis between August 2003 and February 2017...
February 2018: Clinical Orthopaedics and related Research
Anton Khlopas, Morad Chughtai, Randa K Elmallah, David Hip-Flores, Arthur L Malkani, Steven F Harwin, Michael A Mont, Michael D Ries
BACKGROUND: Bone loss in patients undergoing revision THA poses a considerable challenge for orthopaedic surgeons. Often, to achieve better fixation in remaining bone, larger diameter acetabular components and reaming superiorly may be necessary. However, this is likely to raise the hip center of rotation, which may lead to altered biomechanics, specifically, insufficiency of the abductor muscles, altered gait, and increased risk of dislocation from impingement. More recently, a newer acetabular shell has been designed to more closely replicate the native hip center of rotation in these circumstances while maintaining adequate fixation...
February 2018: Clinical Orthopaedics and related Research
Sang-Hyun Park, Zhen Lu, Robert S Hastings, Patricia A Campbell, Edward Ebramzadeh
BACKGROUND: In 2010, a widely used metal-on-metal hip implant design was voluntarily recalled by the manufacturer because of higher than anticipated failure rates at 5 years. Although there was a large published range of revision rates, numerous studies had reported a higher risk of revision for excessive wear and associated adverse tissue reactions when compared with other metal-on-metal total hips. The reasons for this were suggested by some to be related to cup design features. QUESTIONS/PURPOSES: From retrievals of ASR metal-on-metal implants and tissue samples obtained at revision surgery, we asked the following questions: (1) What were the common and uncommon surface features? (2) What were the common and uncommon linear and volumetric wear characteristics? (3) Were there common taper corrosion characteristics? (4) What aseptic lymphocytic vasculitis-associated lesion (ALVAL) features were present in the tissues? METHODS: Five hundred fifty-five ASRs, including 23 resurfacings, were studied at one academic research center...
February 2018: Clinical Orthopaedics and related Research
Susan Mayes, Peter Smith, Jill Cook
OBJECTIVES: Professional ballet dancers may have hip bony morphology that predisposes them to cartilage or labral injury. However, the relationship between bony morphology and pathology has not been investigated in ballet. This study investigates associations between bony morphology, chondrolabral defects and hip pain in ballet dancers. DESIGN: Cross-sectional study. METHODS: 33 male and female professional ballet dancers, (mean age 27 years (range 19-39)), completed questionnaires with hip pain measured on a visual analogue scale; and underwent 3...
March 3, 2018: Journal of Science and Medicine in Sport
K C Geoffrey Ng, Mario Lamontagne, Jonathan R T Jeffers, George Grammatopoulos, Paul E Beaulé
BACKGROUND: As there is a high prevalence of patients with cam deformities and no ongoing hip dysfunction, understanding the biomechanical factors predicting the onset of symptoms and degenerative changes is critical. One such variable is how the spinopelvic parameters may influence hip and pelvic sagittal mobility. Hypothesis/Purpose: Pelvic incidence may predict sagittal hip and pelvic motions during walking and squatting. The purpose was to determine which anatomic characteristics were associated with symptoms and how they influenced functional hip and pelvic ranges of motion (ROMs) during walking and squatting...
March 1, 2018: American Journal of Sports Medicine
Cara L Lewis, Kari L Loverro, Anne Khuu
Study Design Controlled laboratory study, case-control design. Background Despite recognition that femoroacetabular impingement syndrome (FAIS) is a movement-related disorder, few studies have examined dynamic unilateral tasks in individuals with FAIS. Objectives 1) Determine if individuals with FAIS have different pelvis and lower extremity movements than individuals without hip pain during a single leg stepdown. 2) Analyze kinematic differences between males and females within groups. Methods Individuals with FAIS and individuals without hip pain performed a single leg stepdown while kinematic data were collected...
March 6, 2018: Journal of Orthopaedic and Sports Physical Therapy
Robert E Boykin
Patients with radiographic evidence of femoroacetabular impingement and decreased hip internal rotation have a higher rate of anterior cruciate ligament (ACL) tears. Limited internal rotation of the hip increases strain and potentially resultant fatigue failure of the ACL. Although causation has not been proven, a better understanding of the lower extremity kinetic chain may allow improved ACL prevention strategies through measures (operative or nonoperative) to improve rotation of the hip.
March 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
M Bohnsack
OBJECTIVE: Complete arthroscopic decompression of the impinging subspinal soft tissues and resection of the hypertrophic bone formation between the anterior hip capsule and the anterior inferior iliac spine (AIIS) or decompression of a hypertrophic AIIS. INDICATIONS: Painful anterior hip impingement and decreased hip flexion following a hypertrophic osseous subspinal deformation. CONTRAINDICATIONS: No clinical symptoms or decreased anterior hip function despite radiological osseous subspinal hip impingement...
March 2, 2018: Operative Orthopädie und Traumatologie
Matthew P Abdel
Dislocation after revision total hip arthroplasty (THA) continues to be one of the most common and concerning complications after the procedure. As with every hip arthroplasty, it is essential to optimize component positioning, minimize impingement, and maintain the integrity of the abductor complex during the revision THAs. However, in several revision circumstances, additional strategies are required to mitigate the risk of dislocation, particularly those being revised for instability or those with cognitive or neuromuscular disorders...
February 27, 2018: Journal of Arthroplasty
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