Femoral Acetabular Impingement,

INTRODUCTION: Hip impingement from slipped epiphysis and idiopathic cam is well known but not fully differentiated. Idiopathic cam can be a result of an undiagnosed slip. The mechanism of remodeling of slipped epiphysis deformity has also been controversial. The causes of recurrent femoral head deformity and new impingement beyond progression of the slip have not been studied. MATERIALS AND METHODS: A consecutive series of hips treated by arthroscopic femoral neck osteoplasty for impingement from slipped epiphysis were compared with a series of hips treated for idiopathic cam impingement...

PURPOSE: The purpose of this study was to investigate a novel posterior intra-articular hip injection approach while discussing the clinical pearls for methodology, accuracy, and associated adverse events. The goal was to investigate if this approach could potentially be used in those where the typical anterior access would be challenging. MATERIALS AND METHODS: 10 adults (age > 18 years) who were referred to a tertiary outpatient clinic for hip injection due to hip osteoarthritis or femoral acetabular impingement with labral tearing to a single academic sports medicine clinic...

The hip is a uniquely constrained joint with critical static stability provided by the labrum, capsule and capsular ligaments, and ligamentum teres. The labrum is a fibrocartilaginous structure along the acetabular rim that encircles most of the femoral head. Labral tears are localized based on the clock-face method, which determines the extent of the tear while providing consistent terminology for reporting. Normal labral variants can mimic labral disease and can be differentiated by assessment of thickness or width, shape, borders, location, and associated abnormalities...

BACKGROUND: The use of dual mobility (DM) cups has increased quickly. It is hypothesized that femoral neck taper geometry may be involved in the risk of prosthetic impingement and DM cup revision. We aim to (1) explore the reasons for revision of DM cups or head/liners and (2) explore whether certain femoral neck characteristics are associated with a higher risk of revision of DM cups. METHODS: Primary total hip arthroplasties with a DM cup registered in the Dutch Arthroplasty Register between 2007 and 2021 were identified (n = 7603)...

BACKGROUND: The role of acetabular and femoral component positions with respect to the risk of post-operative instability and dislocation remains debated. In this study, we aimed to identify potential risk factors for early dislocation following primary total hip arthroplasty (THA) for displaced intracapsular femoral neck fractures (FNF) using radiological measurements. METHODS: We retrospectively analyzed data for patients who underwent cementless primary THA for FNF using a posterolateral approach between January 2018 and December 2021...

INTRODUCTION: Dual-mobility (DM) implants for total hip arthroplasty (THA) have gained popularity due to their potential to reduce hip instability and dislocation events that may lead to revision surgery. These implants consist of a femoral head articulated within a polyethylene liner, which articulates within an outer acetabular shell, creating a dual-bearing surface. Our study aimed to report our observations on the survivorship of a novel DM implant for primary total hip arthroplasty at two years...

Hip arthroscopy has become increasingly popular in the treatment of femoroacetabular impingement syndrome (FAI). Careful preoperative planning including evaluation of acetabular and femoral version, is necessary to optimize outcomes. Increased femoral anteversion has been associated with microinstability, and conversely, decreased femoral version may predispose to impingement. Computed tomography (CT) is considered the "gold standard" for femoral version measurements and preoperative planning. However, recent advancements in magnetic resonance imaging (MRI) technologies have demonstrated comparable measurements to CT imaging...

OBJECTIVE: The hip joint can be affected by extraspinal diffuse idiopathic skeletal hyperostosis (DISH). This study aimed to compare the clinical characteristics of hips with DISH to those with mixed-type femoroacetabular impingement symptoms (FAIS). In addition, patient-reported outcome (PRO) scores were reported among patients with DISH involving the hip joint who underwent arthroscopic treatment. METHODS: A retrospective analysis was performed using data from patients who underwent hip arthroscopy between 2017 and 2021...

BACKGROUND: Femoral version deformities have recently been identified as a major contributor to femoroacetabular impingement (FAI). An in-depth understanding of the specific labral damage patterns caused by femoral version deformities may help to understand the underlying pathomorphologies in symptomatic patients and select the appropriate surgical treatment. QUESTIONS/PURPOSES: We asked: (1) Is there a correlation between femoral version and the mean cross-sectional area of the acetabular labrum? (2) Is there a difference in the location of lesions of the acetabular labrum between hips with increased femoral version and hips with decreased femoral version? (3) Is there a difference in the pattern of lesions of the acetabular labrum between hips with increased femoral version and hips with decreased femoral version? METHODS: This was a retrospective, comparative study...

Iliopsoas impingement pathology is one of the causes of persistent pain after total hip arthroplasty. It is reported as occurring in approximately 4% of cases; this may be significantly greater (in cases of postarthroplasty pain of unknown etiology). Inflammation is a result of impingement of the tendon against the acetabular component. This may occur with anteroinferior prominence when the cup is properly positioned in anteversion or when the cup is oversized. Other causes of impingement include a cup-reinforcement ring or acetabular cage, a collared femoral component, screws penetrating through the ilium, cement extrusion, anterior wall hypoplasia, or increased femoral offset...

BACKGROUND: Studies have correlated symptomatic femoroacetabular impingement (FAI) with femoral retroversion and cam lesions. PURPOSE: To investigate any association between femoral and acetabular versions with cam deformity in a largely asymptomatic population. STUDY DESIGN: Descriptive laboratory study. METHODS: A total of 986 cadaveric hips were selected from a historical osteologic collection. Each hip was assessed to determine the femoral and acetabular versions, anterior offset, and alpha angle...

BACKGROUND: Hip arthroscopic surgery for femoroacetabular impingement syndrome (FAIS) has proven to be an effective surgical intervention, with high rates of return to sport and work as well as favorable outcomes at short- and midterm follow-up. However, limited data exist on outcomes at long-term follow-up. PURPOSE: To evaluate patient-reported outcomes (PROs) at a minimum 10-year follow-up after primary hip arthroscopic surgery including labral repair, femoral osteochondroplasty, acetabular osteochondroplasty, and capsular closure for FAIS...

PURPOSE: To gather global-expert opinion for the management of patients with femoroacetabular impingement syndrome (FAIS) and Tönnis grade 2 or greater hip osteoarthritis (OA). METHODS: An internet-based modified Delphi methodology was used via an online platform (Online Surveys UK). The expert panel comprised 27 members from 18 countries: 21 (78%) orthopaedic surgeons, 5 (18%) physiotherapists and 1 (4%) dual orthopaedic surgeon and sport and exercise medicine physician...

BACKGROUND: UTE T2* cartilage mapping use in patients undergoing femoroacetabular impingement (FAI) has been lacking but may allow the detection of early cartilage damage. PURPOSE: To assess the reproducibility of UTE T2* cartilage mapping and determine the difference in UTE T2* values between FAI and asymptomatic patients and to evaluate the correlation between UTE T2* values and patient-reported symptoms. MATERIAL AND METHODS: Prospective evaluation of both hips (7 FAI and 7 asymptomatic patients)...

Optimal treatment of patients with femoroacetabular impingement syndrome requires both thoughtful decision-making and skillful operative technique. Traditional evidence-based literature and routine clinical practice overemphasize the role of the alpha angle on the femoral side and lateral center edge angle on the acetabular side. Femoral and acetabular version are critical values that influence outcomes and warrant measurement and consideration. Without version analysis, an uniformed, possibly poor, decision may be made...

OBJECTIVE: In situ fixation for treatment of slipped capital femoral epiphysis (SCFE) can stabilize the epiphysis and prevent further joint deformation but often leaves residual deformity that may adversely affect intra-articular contact mechanics. The purpose of this study was to investigate the relationship between residual deformity and contact mechanics in the post-SCFE hip. METHODS: Patient-specific hip models were created for 19 patients with SCFE treated with in situ fixation...

Although total hip arthroplasty (THA) has proved to be a successful surgical procedure, both prosthetic and bone impingement resulting in dislocation continue to occur. Studies have shown that spine pathology resulting in lumbar stiffness and hip arthritis often coexist. Spinopelvic mobility patterns during postural changes affect three-dimensional acetabular component position, which affects the incidence of prosthetic impingement and THA instability. Several spinopelvic risk factors that may affect THA stability have been identified...

Femoroacetabular impingement (FAI) is a frequent cause of hip pain in young people and athletes. It requires a complete work-up, including X-rays, hip arthro-MRI and CT coxometry with measurement of femoral torsion. The surgical management of CFA must be adapted to the morphological anomalies of the femur (cam), acetabulum (pincer) and femoral torsional disorders. Most CFA can be treated by hip arthroscopy, with correction of the cam and suture of the labrum. Some CFA with a bulky or posterior cam require surgical hip dislocation...

BACKGROUND: The prevalence of chondrolabral lesions due to femoroacetabular impingement (FAI) is 93% in cadaveric material. As a biomechanically determined factor, it can lead to hip destruction and early osteoarthritis in pincer-type impingement. The aim of this work was to study the biomechanism and stress-strain behavior of chondrolabral lesions in pincer-type impingement during daily activity-associated movements. MATERIAL AND METHODS: The SolidWorks package was used to build a 3D pelvis model with and without pincer-type impingement in the femoroacetabular (FA) region...

OBJECTIVES: Clinical, radiological and functional results of the first Spanish series of patients undergoing total hip arthroplasty assisted by Mako® (Stryker) robotic arm at the Hospital Clínico San Carlos (HCSC) in Madrid. MATERIAL AND METHODS: Prospective and descriptive study analyzing the first 25 patients who underwent robotic-assisted THA at the HCSC, with a minimum follow-up of 4 months. Demographics, imaging studies (Mako® processing, Rx and CT), clinical parameters, functionality (modified Harris) and associated complications were evaluated...