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Femoro acetabular impingment

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...
October 12, 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...
September 13, 2016: 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
Vikas Khanduja, Nick Baelde, Andreas Dobbelaere, Jan Van Houcke, Hao Li, Christophe Pattyn, Emmanuel A Audenaert
BACKGROUND: Objective quantification of anatomical variations about the femur head-neck junction in pre-operative planning for surgical intervention in femoro-acetabular impingement is problematic, as no clear definition of average normal anatomy for a specific subject exists. METHODS: We have defined the normal-equivalent of a subject's anatomy by using a statistical shape model and geometric shape optimization for finding correspondences, while excluding the femoral head-neck junction during the fitting procedure...
January 8, 2016: International Journal of Medical Robotics + Computer Assisted Surgery: MRCAS
Paulo Renato Amaral Rego, Vasco Mascarenhas, Filipe S Oliveira, Pedro C Pinto, Augusto Gaspar, Joana Ovídio, Diego G Collado
PURPOSE: The alpha angle is used to quantify in a single plane the head-neck junction deformity of cam femoro-acetabular impingement (FAI). When the deformity overlaps the superior retinaculum, femoral head osteoplasty in this area can jeopardise intra-articular vascular structures. This study proposes a new angular measure of the linear radial extension of cam deformity as a planning tool for bone resection and compares the accuracy of femoral head osteoplasty using open and arthroscopic surgery...
October 2016: International Orthopaedics
P Bartolone, P Christofilopoulos
Different disorders around the hip joint have been diagnosed in athletes of all levels. Pathologies such as femoro-acetabular impingement (FAI) are responsible for lower performance during sports and early onset osteoarthrosis of the hip joint. This article emphasizes on the diagnosis and early treatment of FAI in young athletes. It is meant to raise concern about this relatively new pathology and hence avoid the deleterious results for the hip joint associated with late diagnosis.
July 15, 2015: Revue Médicale Suisse
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...
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
Kevin C McGill, Charles A Bush-Joseph, Shane J Nho
Microfracture is a marrow-stimulating technique used in the hip to treat cartilage defects associated with femoro-acetabular impingement, instability, or traumatic hip injury. These defects have a low probability of healing spontaneously and therefore often require surgical intervention. Originally adapted from the knee, microfracture is part of a spectrum of cartilage repair options that include palliative procedures such as debridement and lavage, reparative procedures such as marrow-stimulating techniques (abrasion arthroplasty and microfracture), and restorative procedures such as autologous chondrocyte implantation and osteochondral allograft/autografts...
April 2010: Cartilage
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
A Berthaudin, M Schindler, J-L Ziltener, J Menetrey
Athletic pubalgia is a painful and complex syndrom encountered by athletes involved in pivoting and cutting sports such as hockey and soccer. To date, there is no real consensus on the criteria for a reliable diagnostic, the different investigations, and the appropriate therapy. Current literature underlines intrinsic and extrinsic factors contributing to athletic pubalgia. This review article reports upon two novelties related to the issue: the importance and efficience of prevention program and the association of femoro-acetabular impingement with the pubalgia...
July 16, 2014: Revue Médicale Suisse
Matthias Lahner, Simone Bader, Philipp Alexander Walter, Christian Duif, Christoph von Schulze Pellengahr, Carsten Lukas, Andreas Ficklscherer, Stefan Fickert, Marco Hagen
PURPOSE: The aim of our study was to analyse the prevalence of femoro-acetabular impingement (FAI) in national elite track and field athletes compared to peers using magnetic resonance imaging (MRI) and clinical examination including impingement tests. METHODS: A total of 44 participants (22 national elite track and field athletes and 22 non-athletes) underwent an MRI for radiological findings associated with FAI, including alpha angle, lateral centre edge angle (CEA), findings of labral and cartilage lesions...
December 2014: International Orthopaedics
Jérôme Murgier, Jérôme Sales de Gauzy, Fouad C Jabbour, Xavier Bayle Iniguez, Etienne Cavaignac, Régis Pailhé, Franck Accadbled
Slipped capital femoral epiphysis (SFCE) may lead to femoro acetabular impingement and long-term function impairment, depending on initial displacement and treatment. There are several therapeutic options which include in situ fixation (ISF). The objective of this study was to evaluate long-term functional and radiographic outcomes of patients with SFCE treated with ISF. We conducted a single-center, retrospective study evaluating the clinical and radiographic outcomes of SCFE in situ fixation with a mean follow-up of 26 years (10-47)...
April 22, 2014: Orthopedic Reviews
Zeiad Alshameeri, Vikas Khanduja
Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn...
August 2014: International Orthopaedics
Peter M Stevens, Lucas A Anderson, Jeremy M Gililland, Eduardo Novais
During the initial fragmentation stage of Perthes disease, the principle focus is to achieve containment of the femoral head within the acetabulum. Whether by bracing, abduction casts, femoral and/or pelvic osteotomy, the goals are to maximize the range of hip motion and to avoid incongruity, hoping to avert subsequent femoro-acetabular impingement or hinge abduction. A more subtle and insidious manifestation of the disease relates to growth disturbance involving the femoral neck. We have chosen to tether the greater trochanteric physis, combined with a medial soft tissue release, as part of our non-osteotomy management strategy for select children with progressive symptomatology and related radiographic changes...
April 2014: Strategies in Trauma and Limb Reconstruction
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