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Femoro-Acetabular Impingement

Louise F Grant, Derek J Cooper, Jon L Conroy
The purpose of this randomized prospective comparative controlled pilot study was to determine whether specific patient exercises done pre-hip arthroscopy surgery for femoro-acetabular impingement affected post-operative recovery. Between October 2013 and June 2014, 6 males and twelve females over the age of eighteen, who were listed for hip arthroscopy for femoro-acetabular impingement, were randomized into two groups. A hip-specific, 8-week home exercise programme was given to the experimental group before their surgery...
January 2017: Journal of Hip Preservation Surgery
Eugenio Jannelli, Andrea Fontana
Chondral lesions are currently considered in the hip as a consequence of trauma, osteonecrosis, dysplasia, labral tears, loose bodies, dislocation, previous slipped capital femoral epiphysis and Femoro-Acetabular-Impingement (FAI). The management of chondral lesions is debated and several techniques are described. The physical examination must be carefully performed, followed by radiographs and magnetic resonance imaging (MRI). Differential diagnosis with other pathologies must be considered. Debridement is indicated in patients younger than 50 years with a chondropathy of 1st or 2nd degree...
2017: SICOT-J
Naoki Nakano, Grace Yip, Vikas Khanduja
PURPOSE: Extra-articular hip impingement syndromes encompass a group of conditions that have previously been an unrecognised source of pain in the hip and on occasion been associated with intra-articular hip impingement as well. As arthroscopic techniques for the hip continue to evolve, the importance of these conditions has been recognised recently and now form an important part of the differential of an individual presenting with hip pain. The aim of this article, therefore, is to provide the reader with an evidence-based and comprehensive update of these syndromes...
April 11, 2017: International Orthopaedics
C Rivière, A Hardijzer, J-Y Lazennec, P Beaulé, S Muirhead-Allwood, J Cobb
Relationship between hip pathoanatomy and symptomatic FAI has been reported to be weak. This is explained by the reciprocal interaction between proximal femur and acetabular anatomies, but potentially also by the individual spine-hip relations (SHR). The key-answer for a complete understanding of the pathophysiology of FAI might lie in the comprehension of the SHRs, which have not yet been fully addressed. Therefore we conducted a systematic review to answer the subsequent questions: Is there any evidence of a relationship between FAI and (1) sagittal pelvic kinematics, (2) pelvic incidence, and (3) types of SHRs? A systematic review of the existing literature utilizing PubMed and Google search engines was performed in December 2016...
June 2017: Orthopaedics & Traumatology, Surgery & Research: OTSR
Andrew D Speirs, Paul E Beaulé, Adrian Huang, Hanspeter Frei
Femoro-acetabular impingement (FAI) is associated with significant acetabular cartilage damage and degenerative arthritis. To understand the contact stress and thus biomechanical mechanisms that may contribute to degeneration, the material behaviour of the cartilage layer is required. The objective of this study is to determine the fibril-reinforced poroelastic properties and composition of cartilage from cam deformities and to compare to those of normal cartilage. Patients undergoing surgical treatment of a symptomatic cam FAI deformity were recruited from the clinical practice of one of the authors...
April 11, 2017: Journal of Biomechanics
Rodrigo Mardones, Alessio Giai Via, Alexander Tomic, Claudio Rodriguez, Matias Salineros, Marcelo Somarriva
BACKGROUND: The iliopsoas tendon is a recognized cause of extra-articular hip pain, and tenotomy has been described as an effective treatment in patients who do not respond to conservative treatments. Endoscopic release showed higher success rate, lower recurrence, fewer complications compared to open surgery. The aim of the study is to report the results at a mean of 4 years follow-up of a series of patients affected by femoroacetabular impingement (FAI) and an associated iliopsoas tendinopathy, treated with hip arthroscopy and transcapsular tendon release...
July 2016: Muscles, Ligaments and Tendons Journal
Michael Wyatt, Jan Weidner, Dominik Pfluger, Martin Beck
BACKGROUND: The definition of osseous instability in radiographic borderline dysplastic hips is difficult. A reliable radiographic tool that aids decision-making-specifically, a tool that might be associated with instability-therefore would be very helpful for this group of patients. QUESTIONS/PURPOSES: (1) To compare a new radiographic measurement, which we call the Femoro-Epiphyseal Acetabular Roof (FEAR) index, with the lateral center-edge angle (LCEA) and acetabular index (AI), with respect to intra- and interobserver reliability; (2) to correlate AI, neck-shaft angle, LCEA, iliocapsularis volume, femoral antetorsion, and FEAR index with the surgical treatment received in stable and unstable borderline dysplastic hips; and (3) to assess whether the FEAR index is associated clinical instability in borderline dysplastic hips...
March 2017: Clinical Orthopaedics and related Research
Ryan Charles, Scott LaTulip, James A Goulet, Aidin Eslam Pour
BACKGROUND: Total hip arthroplasty (THA) is commonly elected following failed arthroscopic treatment of femoro-acetabular impingement (FAI). The purpose of this study was to evaluate post-operative outcomes of primary THA in patients who had previously undergone arthroscopic treatment for FAI. METHODS: A retrospective, matched case-control study was conducted. The case group included 39 patients who underwent THA after previous hip arthroscopy for FAI. Thirty-nine patients who had a primary THA without previous hip arthroscopy served as a control group and were matched for age, sex and body mass index...
June 2017: International Orthopaedics
A Dangin, N Tardy, M Wettstein, O May, N Bonin
With the development of conservative hip surgery techniques, new entities such as microinstability have been identified. Microinstability is a painful supra-physiological mobility of the hip. It results from the association of architectural and functional abnormalities impairing joint stability. These risk factors concern hip joint bone architecture or peri-articular soft tissues. Bone abnormalities are identified on hip assessment parameters. Soft tissues also play a key role in the static and dynamic stability of the hip: the joint capsule, labrum, ligamentum teres and adjacent myotendinous structures affect joint coaptation; any abnormality or iatrogenic lesion concerning these structures may constitute a risk factor for microinstability...
December 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
M D Crema, G J Watts, A Guermazi, Y-J Kim, R Kijowski, F W Roemer
OBJECTIVE: To review and discuss the role of magnetic resonance imaging (MRI) in the context of hip osteoarthritis (OA) research. DESIGN: The content of this narrative review, based on an extensive PubMed database research including English literature only, describes the advances in MRI of the hip joint and its potential usefulness in hip OA research, reviews the relevance of different MRI features in regard to symptomatic and structural progression in hip OA, and gives an outlook regarding future use of MRI in hip OA research endeavors...
January 2017: Osteoarthritis and Cartilage
Justin A Ly, Erin M Coleman, Gary S Cohen, Eric J Kropf
Femoro-acetabular impingement is a common cause of hip pain in young athletes. Evaluation typically includes radiographs and magnetic resonance imaging. It is important to appreciate uncommon diagnoses and the role of complimentary imaging. This clinical vignette emphasizes the need complete imaging with CT in select case of atypical hip pain. We present a 19-year old soccer player who underwent seemingly successful arthroscopic FAI surgery but returned with pain. Computed tomography (CT) revealed osteoid osteoma of the lesser trochanter...
August 2016: Journal of Hip Preservation Surgery
Tadros B J, Stafford G H
INTRODUCTION: Tuberculosis (TB) still remains a common problem in the UK and, with the increasing number of patients being offered arthroplasties; periprosthetic involvement is not uncommon anymore. However, the diagnosis of TB infected arthroplasties still remains difficult and misdiagnosis is common, therefore delaying treatment. CASE REPORT: We describe a 36-years old Caucasian female with no known history of TB who presented with hip pain thought to be due to femoro-acetabular impingement (FAI)...
January 2016: Journal of Orthopaedic Case Reports
Mikael Sansone, Mattias Ahldén, Pall Jonasson, Christoffer Thomeé, Leif Swärd, David Collin, Adad Baranto, Jón Karlsson, Roland Thomeé
Osteoarthritis (OA) of the hip is a common cause of hip pain. The arthroscopic management of patients with femoro-acetabular impingement (FAI) has been reported to yield good outcomes. The purpose of this study was to report on outcome following the arthroscopic treatment of patients with FAI in the presence of mild to moderate OA. Seventy-five patients undergoing arthroscopic surgery for FAI, all with preoperative radiological signs of mild to moderate OA were prospectively included in this study. A 2-year follow-up, using web-based patient-reported outcome measures, including the International Hip Outcome Tool (iHOT-12), Copenhagen Hip and Groin Outcome (HAGOS), EQ-5D, Hip Sports Activity Scale (HSAS) for physical activity level and a visual analogue scale (VAS) for overall hip function, was performed, complemented by a radiographic evaluation...
April 2016: Journal of Hip Preservation Surgery
T Masquefa, N Verdier, O Gille, L Boissière, I Obeid, C Maillot, C Tournier, T Fabre
BACKGROUND: Abnormalities in acetabular orientation can promote the development of hip osteoarthritis, femoro-acetabular impingement, or even acetabular cup malposition. The objective of the present study was to determine whether pedicle substraction osteotomy (PSO) to correct sagittal spinal imbalance affected acetabular orientation. HYPOTHESIS: PSO performed to correct sagittal spinal imbalance affects acetabular orientation by changing the pelvic parameters. MATERIALS AND METHODS: This was a descriptive study in which two observers measured the acetabular parameters on both sides in 19 patients (38 acetabula) before and after PSO for post-operative flat-back syndrome...
October 2015: Orthopaedics & Traumatology, Surgery & Research: OTSR
Signe Kierkegaard, Bent Lund, Ulrik Dalgas, Henrik Sørensen, Kjeld Søballe, Inger Mechlenburg
INTRODUCTION: During the past decade, it has become increasingly more common to offer hip arthroscopic surgery when treating people with femoroacetabular impingement (FAI). Nevertheless, the latest reviews conclude that it still remains to be properly investigated how surgery affects the patients. Specifically, detailed information on the functional, muscular and mechanical impact of surgery in larger groups is lacking. Furthermore, the long-term outcome of the surgery is still to be investigated...
September 7, 2015: BMJ Open
Aloїs Espié, Fanny Elia, Jérôme Murgier, Philippe Chiron, Benoit Chaput
PURPOSE: The head-neck offset described by Eijer et al. (eHNO), which is used to diagnose anterior femoro-acetabular impingement (FAI), can be difficult to measure. The aim of this study was to verify if a modified head-neck offset (mHNO) provides more accurate and reproducible values than those of the eHNO. METHODS: The eHNO, mHNO, cephalic radius and alpha angle were measured on frog-leg radiographs of a group of patients with FAI and a control group (T); three independent reviewers measured the 50 hips in each group twice...
April 2016: International Orthopaedics
Andreas M Hingsammer, David Stelzeneder, Leslie A Kalish, Michael B Millis, Young-Jo Kim
BACKGROUND: We sought to identify, which patient and radiographic factors at preoperative and 1-year follow up will predict patient symptom relief at mid-term. MATERIALS AND METHODS: A total of 50 hips in 47 patients with symptomatic FAI were included in this retrospective study. We stratified the hips into "success" and "failure" groups based on the change from baseline to mid-term follow up WOMAC pain score (mean follow up of 5.8 years). An attempt was made to identify factors that are predictive of mid-term outcome among preoperative radiographic measures, dGEMRIC index, range of motion and WOMAC score as well as 1-year follow-up range of motion, radiographic measures, and WOMAC pain scores...
September 2015: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
Deborah Coady, Stacey Futterman, Dena Harris, Struan H Coleman
OBJECTIVE: We hypothesized that in patients with vulvodynia and femoro-acetabular impingement (FAI), vulvar pain may be generated by the effect of FAI on pelvic floor structures, and treatment with arthroscopy may improve vulvodynia. We also sought to identify characteristics of patients whose vulvodynia improved after arthroscopy. MATERIALS AND METHODS: A case series of patients with vulvodynia and FAI underwent physical therapy, and, if hip symptoms did not improve, arthroscopy...
July 2015: Journal of Lower Genital Tract Disease
Olufemi R Ayeni, Mikael Sansone, Darren de Sa, Nicole Simunovic, Asheesh Bedi, Bryan T Kelly, Forough Farrokhyar, Jon Karlsson
Femoro-acetabular impingement (FAI) is increasingly recognized as an important cause of hip pain in the young adult. However, the methods of evaluating the efficacy of surgical intervention are often not validated and/or inconsistently reported. Important clinical, gait, radiographic and biomarker outcomes are discussed. This article (1) presents the rationale for considering a composite outcome for FAI patients; (2) examines a variety of important end points currently used to evaluate FAI surgery; (3) discusses a strategy to generate a composite outcome by combining these end points; and (4) highlights the challenges and current areas of controversy that such an approach to evaluating symptomatic FAI patients may present...
January 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
T Gicquel, J-E Gédouin, N Krantz, O May, P Gicquel, N Bonin
BACKGROUND: Outcomes after arthroscopic femoro-acetabular impingement (FAI) surgery are promising in the short-term but have rarely been evaluated in the mid-term (e.g., about 5 years). Here, our objectives were to obtain mid-term data on functional and radiographic outcomes, to identify prognostic factors, and to determine the mid-term rate of arthroplasty revision with the associated risk factors. HYPOTHESIS: We hypothesized that the results of arthroscopic FAI surgery were sustained over time...
October 2014: Orthopaedics & Traumatology, Surgery & Research: OTSR
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