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Pincer deformity

Tomohiro Mimura, Kanji Mori, Shin Itakura, Yuki Furuya, Taku Kawasaki, Shinji Imai
BACKGROUND: Femoroacetabular impingement (FAI) is thought to be associated with hip osteoarthritis. We investigated the prevalences of radiologic deformities of the pincer, cam, and their combinations in Japanese hip joints using computed tomography (CT) according to the Japanese Hip Society diagnostic guideline for FAI. METHODS: Multi-slice CT images were evaluated. Pincer deformities were defined as: type 1: center-edge angle (CE) ≥40°; type 2: CE ≥ 30° and acetabular roof obliquity ≤0°; type 3: CE ≥ 25° and retroverted acetabulum...
October 6, 2016: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
Fatemeh Saberi Hosnijeh, Maria E Zuiderwijk, Mathijs Versteeg, Hieronymus T W Smeele, Albert Hofman, André G Uitterlinden, Rintje Agricola, Edwin H G Oei, Jan H Waarsing, Sita M Bierma-Zeinstra, Joyce B J van Meurs
Objectives Cam deformity and acetabular dysplasia have been recognized as relevant risk factors for hip osteoarthritis (OA) in a few prospective studies with limited sample sizes. However, to date, there is no evidence available from prospective studies if the magnitude of these associations differ by gender, body mass index (BMI), and age. Methods Participants of Rotterdam Study cohort including men and women aged 55 years or older without OA at baseline (n=4438) and mean follow-up of 9.2 years were included in the study...
October 1, 2016: Arthritis & Rheumatology
K Mineta, T Goto, K Wada, Y Tamaki, D Hamada, I Tonogai, K Higashino, K Sairyo
AIMS: Femoroacetabular impingement (FAI) has been highlighted and well documented primarily in Western countries and there are few large studies focused on FAI-related morphological assessment in Asian patients. We chose to investigate this subject. PATIENTS AND METHODS: We assessed the morphology of the hip and the prevalence of radiographic FAI in Japanese patients by measuring predictors of FAI. We reviewed a total of 1178 hips in 695 men and 483 women with a mean age of 58...
September 2016: Bone & Joint Journal
Thomas L Sanders, Patrick Reardon, Bruce A Levy, Aaron J Krych
PURPOSE: Few studies have evaluated the role of hip arthroscopy in patients with coxa profunda. The purposes of this study are to (1) report functional hip outcomes after arthroscopic treatment of patients with femoroacetabular impingement (FAI) associated with radiographic coxa profunda and (2) evaluate factors associated with poor hip function at minimum 2 years following surgery in this specific cohort. METHODS: This retrospective review included patients with radiographic sign of coxa profunda who underwent hip arthroscopy to treat FAI...
August 9, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Andrea B Mosler, Kay M Crossley, Jan H Waarsing, Nabil Jomaah, Adam Weir, Per Hölmich, Rintje Agricola
BACKGROUND: Participation in high-impact athletic activities has recently been associated with a higher prevalence of cam deformity. Bony hip morphology has also emerged as an important factor in the development of hip osteoarthritis. However, it is unknown whether bony morphology differs between ethnicities in athletes participating in high-impact sports. PURPOSE: To investigate whether the prevalence of specific bony hip morphological abnormalities differed between professional male soccer players of diverse ethnic backgrounds...
August 4, 2016: American Journal of Sports Medicine
Darrin J Trask, James S Keene
BACKGROUND: Data on the efficacy of microfracture for treatment of chondral defects in the hip are currently limited, and the recommended criteria for its use (minimal osteoarthritis; a focal, contained lesion <4 cm(2) in size) have been taken from those that were established for the knee. PURPOSE: To determine if the current microfracture (ie, knee) criteria are appropriate for chondral lesions in the hip. STUDY DESIGN: Case series; Level of evidence, 4...
July 27, 2016: American Journal of Sports Medicine
Brian C Werner, Michael A Gaudiani, Anil S Ranawat
Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making...
July 2016: Clinics in Sports Medicine
Serdar Altun, Murat Gürger, Enver Arpacı, Emre İnözü
Pincer nail deformity is the extreme, transverse, proximal-to-distal overcurvature of the finger, caused by osteophyte of the distal phalanx, and causing clamp effect on soft tissues and nail ingrowth. We report a new technique consisting of removal of the osteophyte causing clamp effect. Depressed areas of both side of the nail bed (lateral nail fold) were corrected with dermal flaps prepared from the side. Depressed areas were filled by these flaps, creating a smooth surface for the nail bed, and adequate correction was obtained...
2016: Acta Orthopaedica et Traumatologica Turcica
Victor M Ilizaliturri, Pedro Joachin, Marco Acuna
Pincer impingement is often treated by surgical labral separation from the acetabular rim and rim reduction. A more recent technique the so-called 'over the top' involves reduction of the bony acetabular rim without separation of the labrum. Our purpose is to report mid-term results of the 'over the top' technique. Between January 2006 and January 2013 a consecutive series of patients with femoroacetabular impingement (FAI) diagnosis, treated with the 'over the top' technique were included, using the lateral approach...
December 2015: Journal of Hip Preservation Surgery
Dean K Matsuda, Nikhil Gupta, Raoul J Burchette, Bantoo Sehgal
To determine outcomes from arthroscopic surgery for global pincer femoroacetabular impingement (FAI), a large multicenter prospective study investigating arthroscopic surgical outcomes was performed with minimum 2-year follow-up. Global (center-edge angle 40+ degrees) and Focal (center-edge angle 25-39 degrees) cohorts were based on pre-operative radiographs. Pre-operative and intra-operative findings, surgical procedures, post-operative nonarthritic hip score (NAHS) and satisfaction (5-point Likert scale), complications and conversion arthroplasties were compared...
January 2015: Journal of Hip Preservation Surgery
Cohen J Hinzpeter, C Barrientos-Mendoza, A Zamorano-Cárdenas, D Cuzmar-Grimalt, J M Lizama-Calvo, N Plaza-Guzmán
Femoroacetabular impingement is the mechanical contact between the femur and the pelvis, frequently between the femur neck and the acetabular rim, whether due to a deformity of the former (cam type) or the latter (pincer type). However, there may be extraarticular causes of impingement. Together with the increased diagnosis of impingement, arthroscopic treatment is increasingly frequent and has become the standard treatment. This report analyzes a case of extraarticular hip impingement caused by contact between the femur and a prominent anteroinferior iliac spine (AIIS), probably due to a healed old avulsion and its later arthroscopic management...
January 2015: Acta Ortopédica Mexicana
Martin Hufeland, David Krüger, Norbert Peter Haas, Carsten Perka, Jörg Hartmut Schröder
INTRODUCTION: The concept of femoroacetabular impingement (FAI) and the indication for surgical intervention have been established in the last decade. Despite promising short-term results and emerging arthroscopic techniques, it remains unclear whether patients benefit from surgical correction in the mid- to long-term and whether progressive joint degeneration can be prevented. MATERIALS AND METHODS: A retrospective study of our first 50 consecutive patients who underwent arthroscopic correction for FAI was conducted...
May 2016: Archives of Orthopaedic and Trauma Surgery
Frantz Lerebours, William Robertson, Brian Neri, Brian Schulz, Thomas Youm, Orr Limpisvasti
BACKGROUND: Femoroacetabular impingement (FAI) has been increasingly recognized as a cause of hip pain in athletes at all levels of competition, specifically ice hockey players. PURPOSE/HYPOTHESIS: The purpose of this study was to define the prevalence of cam and pincer radiographic deformity in elite ice hockey players. The hypothesis was that elite hockey players will have a higher prevalence of radiographic hip abnormalities compared with the general population...
April 2016: American Journal of Sports Medicine
David M Levy, Michael D Hellman, Joshua D Harris, Bryan Haughom, Rachel M Frank, Shane J Nho
Cam and pincer are two common morphologies responsible for femoroacetabular impingement (FAI). Previous literature has reported that cam deformity is predominantly a male morphology, while being significantly less common in females. Cam morphology is commonly assessed with the alpha angle, measured on radiographs. The purpose of this study is to determine the prevalence of cam morphology utilizing the alpha angle in female subjects diagnosed with symptomatic FAI. All females presenting to the senior author's clinic diagnosed with symptomatic FAI between December 2006 and January 2013 were retrospectively reviewed...
2015: Frontiers in Surgery
Ettore Sabetta, Edoardo Scaravella
Pincer femoroacetabular impingement (FAI) consists of pathological contact between the acetabular labrum and rim and the femoral head-neck junction. Manifold conditions underlie pincer FAI: anatomical abnormalities, malorientation of the acetabulum, torsional abnormalities of the neck and femoral shaft (these defects can be constitutional, post-traumatic or post-surgical), and involvement in sports characterized by repeated and sudden maximum joint excursions. In a high percentage of cases, pincer FAI is associated with cam FAI...
April 2015: Joints
Joshua D Harris, Brayden J Gerrie, Kevin E Varner, David M Lintner, Patrick C McCulloch
BACKGROUND: The demands of hip strength and motion in ballet are high. Hip disorders, such as cam and pincer deformities or dysplasia, may affect dance performance. However, the prevalence of these radiographic findings is unknown. PURPOSE: To determine the prevalence of radiographic cam and pincer deformities, borderline dysplasia, and dysplasia in a professional ballet company. STUDY DESIGN: Cross-sectional study; Level of evidence, 3. METHODS: An institutional review board-approved cross-sectional investigation of a professional ballet company was undertaken...
January 2016: American Journal of Sports Medicine
Sanjeev Bhatia, Simon Lee, Elizabeth Shewman, Richard C Mather, Michael J Salata, Charles A Bush-Joseph, Shane J Nho
BACKGROUND: In patients with femoroacetabular impingement (FAI), acetabular rim trimming removes the offending area of the acetabular deformity in patients with pincer-type and mixed-type FAI to improve hip joint kinematics. Although the rationale for arthroscopic acetabular rim trimming in patients with FAI is well established, the amount of rim resection has not been quantified, and the threshold at which excessive rim resection results in abnormal hip contact pressures has not been described...
September 2015: American Journal of Sports Medicine
Pascal Cyrill Haefeli, Simon Damian Steppacher, Doris Babst, Klaus Arno Siebenrock, Moritz Tannast
BACKGROUND: The iliocapsularis muscle is an anterior hip structure that appears to function as a stabilizer in normal hips. Previous studies have shown that the iliocapsularis is hypertrophied in developmental dysplasia of the hip (DDH). An easy MR-based measurement of the ratio of the size of the iliocapsularis to that of adjacent anatomical structures such as the rectus femoris muscle might be helpful in everyday clinical use. QUESTIONS/PURPOSES: We asked (1) whether the iliocapsularis-to-rectus-femoris ratio for cross-sectional area, thickness, width, and circumference is increased in DDH when compared with hips with acetabular overcoverage or normal hips; and (2) what is the diagnostic performance of these ratios to distinguish dysplastic from pincer hips? METHODS: We retrospectively compared the anatomy of the iliocapsularis muscle between two study groups with symptomatic hips with different acetabular coverage and a control group with asymptomatic hips...
December 2015: Clinical Orthopaedics and related Research
Vandit Sardana, Marc J Philippon, Darren de Sa, Asheesh Bedi, Lily Ye, Nicole Simunovic, Olufemi R Ayeni
PURPOSE: To identify the indications and outcomes in patients undergoing revision hip arthroscopy. METHODS: The electronic databases Embase, Medline, HealthStar, and PubMed were searched from 1946 to July 19, 2014. Two blinded reviewers searched, screened, and evaluated the data quality of the studies using the Methodological Index for Non-Randomized Studies scale. Data were abstracted in duplicate. Agreement and descriptive statistics are presented. RESULTS: Six studies were included (3 prospective case series and 3 retrospective chart reviews), with a total of 448 hips examined...
October 2015: Arthroscopy: the Journal of Arthroscopic & related Surgery
Young Joo Cho, Jae Hoon Lee, Dong Jun Shin, Woo Young Sim
BACKGROUND: Pincer nail is a deformity characterized by excessive transverse curvature of the nail plate that increases distally for which many conservative and surgical corrective modalities have been recommended. OBJECTIVE: The purpose of this study is to investigate the outcomes and safety of modified double Z-plasty in the management of symptomatic pincer nail. MATERIALS AND METHODS: Modified double Z-plasty has been performed on 20 great toes in 12 patients from January 2008 to December 2013...
June 2015: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
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