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Femoroacetabular impingment

Benedict U Nwachukwu, Kara Fields, Brenda Chang, Danyal H Nawabi, Bryan T Kelly, Anil S Ranawat
BACKGROUND: There is increasing interest in defining meaningful improvement in patient-reported outcomes. Knowledge of the thresholds and determinants for successful femoroacetabular impingement (FAI) outcomes is evolving. PURPOSE: To define preoperative outcome score thresholds and determine clinical/demographic patient factors predictive for achieving the minimal clinically important difference (MCID) after arthroscopic FAI surgery. STUDY DESIGN: Cohort study (diagnosis); Level of evidence, 2...
October 20, 2016: American Journal of Sports Medicine
Daniel W Griffin, Matthew J Kinnard, Peter M Formby, Michael P McCabe, Terrence D Anderson
BACKGROUND: The indications for hip preservation surgery have expanded to include treatment of hip pathology in older adults. While several studies have examined the efficacy of hip arthroscopy in the setting of osteoarthritis, there has been no review of outcomes in older adults. PURPOSE: To review the outcomes of hip arthroscopy in older adults and identify factors associated with treatment failures. STUDY DESIGN: Systematic review. METHODS: PubMed, EMBASE, and the Cochrane Library were searched through March 2016 for studies reporting outcomes of primary hip arthroscopy in patients older than 40 years...
October 18, 2016: American Journal of Sports Medicine
Roberto Seijas, Andrea Sallent, María Galán, Pedro Alvarez-Diaz, Oscar Ares, Ramón Cugat
BACKGROUND: Hip arthroscopy is considered a safe procedure, considering the relatively low rate of complications. Despite several complications have been described following this surgical procedure, the present event has not yet been described. The purpose of the present study is to report an unpublished complication following hip arthroscopy, after reviewing 162 hip arthroscopies and finding iliotibial band syndrome (ITBS) in the knee during followup. MATERIALS AND METHODS: A retrospective review of 162 hip arthroscopies performed between September 2007 and June 2011 was carried out, evaluating patients who presented ITBS during followup...
September 2016: Indian Journal of Orthopaedics
Helen Anwander, Klaus A Siebenrock, Moritz Tannast, Simon D Steppacher
BACKGROUND: Since the importance of an intact labrum for normal hip function has been shown, labral reattachment has become the standard method for open or arthroscopic treatment of hips with femoroacetabular impingement (FAI). However, no long-term clinical results exist evaluating the effect of labral reattachment. A 2-year followup comparing open surgical treatment of FAI with labral resection versus reattachment was previously performed at our clinic. The goal of this study was to report a concise followup of these patients at a minimum of 10 years...
October 15, 2016: Clinical Orthopaedics and related Research
Dagang Zhang, Long Chen, Guanglin Wang
BACKGROUND: This meta-analysis aims to evaluate the efficacy and safety of hip arthroscopy versus open surgical dislocation for treating femoroacetabular impingement (FAI) through published clinical trials. METHODS: We conducted a comprehensive literature search using PUBMED, EMBASE, and the Cochrane Central Register of Controlled Trials databases for relevant studies on hip arthroscopy and open surgical dislocation as treatment options for FAI. RESULTS: Compared with open surgical dislocation, hip arthroscopy resulted in significantly higher Nonarthritic Hip Scores (NAHS) at 3- and 12-month follow-ups, a significant improvement in NAHS from preoperation to 3 months postoperation, and a significantly lower reoperation rate...
October 2016: Medicine (Baltimore)
Michael A Samaan, Benedikt J Schwaiger, Matthew C Gallo, Thomas M Link, Alan L Zhang, Sharmila Majumdar, Richard B Souza
BACKGROUND: Femoroacetabular impingement (FAI) is a morphological abnormality of the hip joint that causes pain when performing a mechanically demanding activity of daily living such as the sit-to-stand (STS) task. Previous studies have assessed lower extremity joint mechanics during a STS task in various pathologies yet the STS task has not been studied in FAI patients. OBJECTIVE: To identify differences in joint kinetics and performance between FAI patients and healthy controls during a STS task...
October 8, 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Megan K Mills, Colin D Strickland, Mary K Jesse, Peter A Lowry, Omer Mei-Dan, Jonathan A Flug
Osteoarthritis of the hip remains a prevalent disease condition that influences ever-changing treatment options. Procedures performed to correct anatomic variations, and, in turn, prevent or slow the progression of osteoarthritis, are aptly referred to as types of hip preservation surgery (HPS). Conditions that predispose individuals to femoroacetabular impingement (FAI), including pincer- and cam-type morphology, and hip dysplasia are specifically targeted in HPS. Common surgical interventions include acetabuloplasty, osteochondroplasty, periacetabular osteotomy (PAO), and derotational femoral osteotomy (DFO)...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Tarek M Hegazi, Jeffrey A Belair, Eoghan J McCarthy, Johannes B Roedl, William B Morrison
Injuries of the hip and surrounding structures represent a complex and commonly encountered scenario in athletes, with improper diagnosis serving as a cause of delayed return to play or progression to a more serious injury. As such, radiologists play an essential role in guiding management of athletic injuries. Familiarity with hip anatomy and the advantages and limitations of various imaging modalities is of paramount importance for accurate and timely diagnosis. Magnetic resonance (MR) imaging is often the modality of choice for evaluating many of the injuries discussed, although preliminary evaluation with conventional radiography and use of other imaging modalities such as ultrasonography (US), computed tomography, and bone scintigraphy may be supplementary or preferred in certain situations...
October 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
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
Alexander E Weber, Benjamin D Kuhns, Gregory L Cvetanovich, Paul B Lewis, Richard C Mather, Michael J Salata, Shane J Nho
PURPOSE: The purpose of this study was to examine the hip capsule in a subset of symptomatic patients who underwent capsular closure during hip arthroscopy. METHODS: All patients undergoing primary hip arthroscopy for femoroacetabular impingement (FAI) with routine capsular closure between January 1, 2012, and December 31, 2015, were eligible. Only patients with unilateral surgery and a postoperative magnetic resonance imaging (MRI; ordered for persistent symptoms) were included...
October 5, 2016: Arthroscopy: the Journal of Arthroscopic & related Surgery
Pascal Cyrill Haefeli, Christoph Emanuel Albers, Simon Damian Steppacher, Moritz Tannast, Lorenz Büchler
BACKGROUND: In recent years, surgical treatment of symptomatic femoroacetabular impingement (FAI) has been increasingly performed using arthroscopy. Bony pathomorphologies and damage to the labrum as well as cartilage defects can be addressed with comparable results to open surgery with overall less surgery-related complications. Despite the increasing importance of hip arthroscopy, however, reports on midterm clinical and radiographic outcomes and comparison to open surgical hip dislocation are scarce...
October 7, 2016: Clinical Orthopaedics and related Research
Peter C Emary, John A Taylor
Femoroacetabular impingement is a relatively new clinical entity only recently described in the orthopedic literature. In this report, we document a severe case of hip joint osteoarthritis associated with cam-type impingement in a retired chiropractor.
September 2016: Journal of the Canadian Chiropractic Association
Young Kyun Lee, Guen Young Lee, Joon Woo Lee, Eugene Lee, Heung Sik Kang
We evaluated and compared the effectiveness of intra-articular injection of hip joint using hyaluronic acid and steroid in patients with femoroacetabular impingement (FAI). Thirty patients with FAI clinically and radiologically were enrolled and underwent hip injection using steroid (TA) or hyaluronic acid (HA) at 0-weeks with cross-over injection at 2-weeks in patients without clinical response of decrease of pain intensity less than 2-point. Patients were followed up to 12-weeks for pain intensity (Numeric rating scale, NRS: 0-10), hip disability score (HOOS), oral medication and adverse events...
November 2016: Journal of Korean Medical Science
Florian Schmaranzer, Pascal C Haefeli, Markus S Hanke, Emanuel F Liechti, Stefan F Werlen, Klaus A Siebenrock, Moritz Tannast
BACKGROUND: Delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) allows an objective, noninvasive, and longitudinal quantification of biochemical cartilage properties. Although dGEMRIC has been used to monitor the course of cartilage degeneration after periacetabular osteotomy (PAO) for correction of hip dysplasia, such longitudinal data are currently lacking for femoroacetabular impingement (FAI). QUESTIONS/PURPOSES: (1) How does the mean acetabular and femoral dGEMRIC index change after surgery for FAI at 1-year followup compared with a similar group of patients with FAI treated without surgery? (2) Does the regional distribution of the acetabular and femoral dGEMRIC index change for the two groups over time? (3) Is there a correlation between the baseline dGEMRIC index and the change of patient-reported outcome measures (PROMs) at 1-year followup? (4) Among those treated surgically, can dGEMRIC indices distinguish between intact and degenerated cartilage? METHODS: We performed a prospective, comparative, nonrandomized, longitudinal study...
October 5, 2016: Clinical Orthopaedics and related Research
Andrea M Spiker, Christopher L Camp, Brian T Barlow, Shawn G Anthony, Struan H Coleman
This article describes the use of sutures to enhance visualization while protecting the capsule in both the central and peripheral compartments during hip arthroscopy. We describe first a technique to preserve the proximal capsule cuff while working in the central compartment and then an alternative to the T-capsulotomy while maintaining excellent visualization of the peripheral compartment during femoroplasty of cam-type femoroacetabular impingement. By use of suture suspension of the capsule, multiple goals are achieved: The integrity of the proximal capsule cuff is maintained while aiding in visualization of the central compartment; the iliofemoral ligament is spared, which plays a critical role in preventing microinstability; the necessary space is created to obtain adequate visualization of the peripheral compartment for complete femoroplasty; and operative time is reduced because creation and subsequent repair of the T-capsulotomy can be avoided...
August 2016: Arthroscopy Techniques
Stephen K Aoki, James T Beckmann, James D Wylie
Arthroscopic osteochondroplasty has become the most common treatment for cam-type femoroacetabular impingement. However, gauging the appropriate depth and location of the femoral osteochondroplasty remains challenging, given the parallax observed from using a 70° arthroscope across multiple viewing perspectives. Consequently, reliable techniques must use a combination of arthroscopic and fluoroscopic checks and balances to assess the femoral head-neck junction to help guide bony resection. We have developed a technique for osteochondroplasty that has made the process more efficient and reliable in our hands...
August 2016: Arthroscopy Techniques
Brian Cohen, Dominic Kleinhenz, Jonathan Schiller, Ramin Tabaddor
Athletic Pubalgia, more commonly known as sports hernia, is defined as chronic lower abdominal and groin pain without the presence of a true hernia. It is increasingly recognized in athletes as a source of groin pain and is often associated with other pathology. A comprehensive approach to the physical exam and a strong understanding of hip and pelvic anatomy are critical in making the appropriate diagnosis. Various management options are available. We review the basic anatomy, patholophysiology, diagnostic approach and treatment of athletic pubalgia as well as discuss associated conditions such as femoroacetabular impingement...
October 4, 2016: Rhode Island Medical Journal
Kotaro R Shibata, Shuichi Matsuda, Marc R Safran
PURPOSE: The purpose of this study was to determine whether or not there is a distinct pattern of injury to the acetabular labrum and/or cartilage in the hip with instability without bony dysplasia. METHODS: Surgical records and intra-operative images of consecutive patients who underwent primary hip arthroscopy for femoroacetabular impingement (FAI) and/or hip instability by the senior author from April 2007 to December 2014 were retrospectively reviewed. Pathological changes were documented and charted on a novel diagram of the acetabulum, and classified into eight patterns corresponding to the lesion's location and size...
October 1, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
Daniel Camara Azevedo, Edson Barreto Paiva, Alexia Moura Abuhid Lopes, Henrique de Oliveira Santos, Ricardo Luiz Carneiro, André Soares Rodrigues, Marco Antonio Percope de Andrade, Eduardo N Novais, Linda R Van Dillen
Study Design Cross-sectional, case-control design. Background Pelvic movement has been considered a possible discriminating parameter associated with FAI symptom onset. Decreased pelvic rotation has been found during squatting in people with FAI when compared to hip-healthy people. However, it is possible that changes in pelvic movement may occur in other hip conditions because of pain and may not be specific to FAI. Objectives To compare sagittal pelvic rotation during hip flexion and in sitting between people with Femoroacetabular Impingement (FAI) and people with other symptomatic hip conditions...
September 29, 2016: Journal of Orthopaedic and Sports Physical Therapy
Joel Narveson, Matthew D Haberl, Patrick J Grabowski
Study Design Case report. Background Intra-articular hip pathologies can be difficult to diagnose, and evidence to guide physical therapy interventions is lacking. The purpose of this report is to describe a clinical pathway for conservative management of a patient with an acute acetabular labral tear (ALT) and femoroacetabular impingement (FAI). Case Description The patient was an 18-year-old woman with recent onset of right groin pain who underwent intra-articular corticosteroid injection and therapeutic exercise for the management of an acute ALT identified on radiographic imaging...
September 29, 2016: Journal of Orthopaedic and Sports Physical Therapy
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