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Femoroacetabular impingement

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
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 Przybyl, K Walenczak, M E Domzalski
BACKGROUND: Arthroscopic surgery is becoming popular in the management of hip pathologies. There are numerous studies describing the outcomes of the treatment of athletes with this method. These outcomes are generally found to be excellent. Yet there are little data in the literature with respect to the arthroscopic treatment of nonathletes. The objective of our study is to compare the outcomes of the femoroacetabular impingement (FAI) treatment between athletes and nonathletes using arthroscopy, using two popular scales...
January 2018: Journal of Orthopaedic Surgery
Dean K Matsuda, Kaycee Ching, Nicole A Matsuda
Many patients are afflicted with painful conditions affecting both hips, most commonly femoroacetabular impingement. Some patients prefer the advantage of undergoing a single surgical procedure and anesthetic followed by a single postoperative rehabilitation program. We present a Technical Note on single-stage bilateral hip arthroscopy. This Technical Note reports on key steps enabling safe and efficient performance of bilateral arthroscopic acetabuloplasty, labral refixation, femoroplasty, and dynamic testing while limiting traction times and facilitating rapid transition to the second hip arthroscopic surgery...
August 2017: Arthroscopy Techniques
Tobias Hesper, Sarah D Bixby, Daniel A Maranho, Patricia Miller, Young-Jo Kim, Eduardo N Novais
BACKGROUND: Hip osteoarthritis has been reported in the contralateral hip in patients who had been treated for unilateral slipped capital femoral epiphysis (SCFE) during adolescence. Although this might be related to the presence of a mild deformity, the morphologic features of the contralateral hip in unilateral SCFE remains poorly characterized. QUESTIONS/PURPOSES: Do measurements of (1) femoral head-neck concavity (α angle and femoral head-neck offset), (2) epiphyseal extension into the metaphysis (epiphyseal extension ratio and epiphyseal angle), and (3) posterior tilt of the epiphysis (epiphyseal tilt angle) differ between the contralateral asymptomatic hips of patients treated for unilateral SCFE and hips of an age- and sex-matched control population without a history of hip disease? METHODS: From January 2005 to May 2015, 442 patients underwent surgical treatment for SCFE at our institution...
February 23, 2018: Clinical Orthopaedics and related Research
Kyle R Sochacki, Robert A Jack, Arya Bekhradi, Domenica Delgado, Patrick C McCulloch, Joshua D Harris
PURPOSE: To determine if there are significant differences in preoperative patient-reported outcome (PRO) scores in patients with and without self-reported medication allergies undergoing hip arthroscopy. METHODS: Consecutive subjects undergoing hip arthroscopy for femoroacetabular impingement (FAI) syndrome by a single surgeon were retrospectively reviewed. PROs were collected within 6 weeks of the date of surgery. PROs included International Hip Outcome Tool (iHOT-12), Hip Outcome Score (HOS), and Short-Form (SF-12) scores...
February 21, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Sergio E Flores, Kristina R Borak, Alan L Zhang
Background: Hip arthroscopic surgery is a rapidly growing procedure, but it may be associated with a steep learning curve. Few studies have used patient-reported outcome (PRO) surveys to investigate the relationship between surgeon experience and patient outcomes after the arthroscopic treatment of femoroacetabular impingement (FAI). Hypothesis: Patients undergoing hip arthroscopic surgery for the treatment of FAI in the early stages of a surgeon's career will have significantly worse outcomes and longer procedure times compared with patients treated after the surgeon has gained experience...
February 2018: Orthopaedic Journal of Sports Medicine
Renato Locks, Ioanna K Bolia, Hajime Utsunomiya, Karen K Briggs, Marc J Philippon
PURPOSE: To determine the causes of revision hip arthroscopy in patients who underwent labral reconstruction and to compare outcomes of these patients with patients who did not require a revision following reconstruction. METHODS: Patients who underwent revision hip arthroscopy after previous labral reconstruction from 2006 to 2014 were included. Patients with less than 2-year follow-up, preoperative joint space of ≤2 mm, or who underwent other reconstructive procedures at the time of labral reconstruction were excluded...
February 15, 2018: Arthroscopy: the Journal of Arthroscopic & related Surgery
Giovanni Trisolino, Stefano Stilli, Giovanni Gallone, Pedro Santos Leite, Giovanni Pignatti
Background and purpose - The best treatment option for severe slipped capital femoral epiphysis (SCFE) is still controversial. We compared clinical and radiographic outcomes of modified Dunn procedure (D) and in situ fixation (S) in severe SCFE. Patients and methods - We retrospectively compared D and S, used for severe stable SCFE (posterior sloping angle (PSA) > 50°) in 29 patients (15 D; 14 S). Propensity analysis and inverse probability of treatment weights (IPTW) to adjust for baseline differences were performed...
February 16, 2018: Acta Orthopaedica
Nancy S Mansell, Daniel I Rhon, John Meyer, John M Slevin, Bryant G Marchant
BACKGROUND: Arthroscopic hip surgery has risen 18-fold in the past decade; however, there is a dearth of clinical trials comparing surgery with nonoperative management. PURPOSE: To determine the comparative effectiveness of surgery and physical therapy for femoroacetabular impingement syndrome. STUDY DESIGN: Randomized controlled trial; Level of evidence, 1. METHODS: Patients were recruited from a large military hospital after referral to the orthopaedic surgery clinic and were eligible for surgery...
February 1, 2018: American Journal of Sports Medicine
Rachel M Frank, Gift Ukwuani, Bradley Allison, Ian Clapp, Shane J Nho
BACKGROUND: Femoroacetabular impingement syndrome (FAIS) is most commonly diagnosed in patients who perform activities that require repetitive hip flexion and rotational loading. Yoga is an activity growing in popularity that involves these motions. The purpose of this study was to evaluate patients' ability to return to yoga after hip arthroscopy for FAIS. HYPOTHESIS: There would be a high rate of return to yoga after hip arthroscopy. STUDY DESIGN: Retrospective analysis...
February 1, 2018: Sports Health
Ashley L Kapron, Stephen K Aoki, Jeffrey A Weiss, Aaron J Krych, Travis G Maak
PURPOSE: Develop a framework to quantify the size, location and severity of femoral and acetabular-sided cartilage and labral damage observed in patients undergoing hip arthroscopy, and generate a database of individual defect parameters to facilitate future research and treatment efforts. METHODS: The size, location, and severity of cartilage and labral damage were prospectively collected using a custom, standardized post-operative template for 100 consecutive patients with femoroacetabular impingement syndrome...
February 13, 2018: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Christian Dippmann, Otto Kraemer, Bent Lund, Michael Krogsgaard, Per Hölmich, Martin Lind, Karen Briggs, Marc Philippon, Bjarne Mygind-Klavsen
INTRODUCTION: Hip arthroscopy has become a standard procedure in the treatment of hip joint pain not related to osteoarthritis or dysplasia in the young and active patient. There has been increasing focus on the contribution of the hip capsule to function and on stability following hip arthroscopy. It has been suggested that capsular closure after hip arthroscopy may prevent microinstability and macroinstability of the hip joint and reduce revision rate. However, it remains unknown whether capsular closure should be performed as a standard procedure when performing hip arthroscopies, especially in patients without additional risk factors for instability such as hypermobility or dysplasia of the hip...
February 10, 2018: BMJ Open
Matthew G King, Peter R Lawrenson, Adam I Semciw, Kane J Middleton, Kay M Crossley
OBJECTIVE: (1) Identify differences in hip and pelvic biomechanics in patients with femoroacetabular impingement syndrome (FAIS) compared with controls during everyday activities (eg, walking, squatting); and (2) evaluate the effects of interventions on hip and pelvic biomechanics during everyday activities. DESIGN: Systematic review. DATA SOURCES: Medline, CINAHL, EMBASE, Scopus and SPORTDiscus until February 2017. METHODS: Primary aim: studies that investigated hip or pelvic kinematics and/or joint torques of everyday activities in patients with FAIS compared with the asymptomatic contralateral limb or a control group...
February 13, 2018: British Journal of Sports Medicine
Derrick M Knapik, Joe Sheehan, Shane J Nho, James E Voos, Michael J Salata
Background: Intra-articular injuries to the hip in elite athletes represent a source of significant pain and disability. Hip arthroscopic surgery has become the gold standard for the treatment of disorders involving the hip joint. Purpose: To examine the incidence of and abnormalities treated with hip arthroscopic surgery as well as the impact on future participation in American football athletes invited to the National Football League (NFL) Scouting Combine with a history of hip arthroscopic surgery...
February 2018: Orthopaedic Journal of Sports Medicine
J Örtegren, P Peterson, J Svensson, C J Tiderius
OBJECTIVE: Slipped capital femoral epiphysis (SCFE) in adolescence is associated with increased risk of future osteoarthritis (OA). The purpose of this study was to study clinical and radiographic risk factors for early cartilage degeneration after SCFE. DESIGN: 22 patients (44 hips) (mean age 24 years, range 18-27) treated with in situ fixation (The Hansson hook-pin) for stable SCFE on average 11 years previously were investigated. Cartilage status was assessed with delayed gadolinium-enhanced magnetic resonance imaging of cartilage (dGEMRIC)...
February 7, 2018: Osteoarthritis and Cartilage
Andrea M Spiker, Ben-Zion Rotter, Brenda Chang, Douglas N Mintz, Bryan T Kelly
Intra-articular osteoid osteoma (IAOO) of the hip is a relatively rare diagnosis, but one that can closely mimic symptomatic presentation of femoroacetabular impingement (FAI). Although there are multiple case reports of osteoid osteoma (OO) in the hip, we present the largest case series of hip IAOO treated with hip arthroscopy and discuss limited patient-reported outcomes after treatment with hip arthroscopy. We retrospectively identified patients diagnosed with IAOO of the hip with confirmatory computed tomography, magnetic resonance imaging or biopsy diagnoses of OO...
January 2018: Journal of Hip Preservation Surgery
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