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Pincer deformity

Sivashankar Chandrasekaran, Nader Darwish, Edwin O Chaharbakhshi, Carlos Suarez-Ahedo, Parth Lodhia, Benjamin G Domb
BACKGROUND: Advancements in instrumentation and techniques have extended the scope of hip arthroscopic surgery to treat complex osseous deformities that were previously best addressed with an open approach. Global pincer-type femoroacetabular impingement is an example of an abnormality requiring osseous correction with a technically challenging access point. PURPOSE: To report on the patterns of clinical presentation and intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopic surgery in patients with a lateral center edge angle (LCEA) >40° and profunda acetabulae in comparison with matched controls with normal acetabular coverage...
June 1, 2017: American Journal of Sports Medicine
T H V Azevedo, C L S Neiva, R V Consoli, A C D Couto, A F M P Dias, E J R Souza
Pincer nail is a transverse overcurvature of the nail plate that may appear in association with a variable number of diseases. We present a case report of a 28-year-old woman with pincer nail deformity associated with systemic lupus erythematosus. A renal biopsy confirmed class V lupus nephritis and treatment had included systemic steroids and cyclophosphamide. After 6 months there was a marked improvement of nail deformities.
January 1, 2017: Lupus
Jonathan M Frank, Jorge Chahla, Justin J Mitchell, Eduardo Soares, Marc J Philippon
Femoroacetabular impingement (FAI) is an increasingly recognized cause of hip pain. This pathology often involves abnormal femoral neck shape (cam-type FAI), acetabular over coverage (pincer-type FAI), or mixed pathology. Surgical treatment of this entity includes labral repair and femoral head-neck osteochondroplasty. A mindful arthroscopic technique is of paramount importance, because maintaining the integrity of the labrum and a corresponding neck volume has been reported to be vital in maintaining the hip suction seal...
December 2016: Arthroscopy Techniques
Fernando Comba, Carlos Yacuzzi, Pablo J Ali, Gerardo Zanotti, Martin Buttaro, Francisco Piccaluga
BACKGROUND: The purpose of this study is to evaluate the clinical outcomes, radiological degenerative progression and the joint preservation rate in a series of patients with Femoroacetabular Impingement (FAI) treated with hip arthroscopy at a minimum follow-up of 7 years. The predictive factors for total hip arthroplasty (THA) requirement were analyzed. MATERIALS AND METHODS: Between February 2008 and February 2009, 42 consecutive patients treated with hip arthroscopy due to FAI syndrome were included...
July 2016: Muscles, Ligaments and Tendons Journal
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
OBJECTIVE: 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. To date, however, no evidence is available from prospective studies regarding whether the magnitude of these associations differs according to sex, body mass index (BMI), and age. METHODS: Participants in the Rotterdam Study cohort including men and women ages 55 years or older without OA at baseline (n = 4,438) and a mean follow-up of 9...
January 2017: 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...
January 2017: 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...
December 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
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