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Femural impingement

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https://www.readbyqxmd.com/read/28712801/the-effect-of-pelvic-tilt-and-femoral-head-size-on-hip-range-of-motion-to-impingement
#1
Thomas F McCarthy, Jim Nevelos, Randa K Elmallah, Morad Chughtai, Anton Khlopas, Vincent Alipit, Timothy C Wagner, Michael A Mont
BACKGROUND: About 50%-70% of dislocators have cups placed within so-called "safe zones." It has been postulated that factors such as femoral head size and pelvic tilt, obliquity, or rotation may influence postoperative stability. Therefore, we assessed varying degrees of pelvic tilt and head sizes on the range of motion (ROM) to impingement. METHODS: A hip simulator was used to import models of 10 subjects who performed object pickup, squatting, and low-chair rising...
June 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28682639/in-vivo-measurements-of-the-ischiofemoral-space-in-recreationally-active-participants-during-dynamic-activities-a-high-speed-dual-fluoroscopy-study
#2
Penny R Atkins, Niccolo M Fiorentino, Stephen K Aoki, Christopher L Peters, Travis G Maak, Andrew E Anderson
BACKGROUND: Ischiofemoral impingement (IFI) is a dynamic process, but its diagnosis is often based on static, supine images. PURPOSE: To couple 3-dimensional (3D) computed tomography (CT) models with dual fluoroscopy (DF) images to quantify in vivo hip motion and the ischiofemoral space (IFS) in asymptomatic participants during weightbearing activities and evaluate the relationship of dynamic measurements with sex, hip kinematics, and the IFS measured from axial magnetic resonance imaging (MRI)...
July 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28673601/femoroacetabular-impingement-causes-osteoarthritis-of-the-hip-by-migration-and-micro-instability-of-the-femoral-head
#3
Henk Eijer, Tom Hogervorst
Femoroacetabular impingement is the condition whereby parts of the proximal femur mechanically collide with the acetabular rim leading to adjacent and contrecoup acetabular damage. Evidence is growing that at least for cam impingement, and perhaps less so for pincer impingement, there is a relation to the development of osteoarthritis. It has been demonstrated that surgery for impingement can improve function and decrease pain. Intuitively, it would then make sense that surgical intervention would prevent further degeneration...
July 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28630736/abnormal-femoral-antetorsion-a-subtrochanteric-deformity
#4
Guy Waisbrod, Florian Schiebel, Martin Beck
Femoral rotational malalignment is associated with pain and functional disability and may be a contributing factor to hip impingement as well as to instability. In general, the deformity can be addressed surgically by rotational osteotomy. However, the anatomic location of the deformity is debated. The goal of the present study was to narrow down the anatomic site of deformity using the lesser trochanter (LT) as an additional landmark. One hundred and eight patients underwent computer tomography (CT)-based rotational analysis of their lower extremities...
July 2017: Journal of Hip Preservation Surgery
https://www.readbyqxmd.com/read/28611961/radiographic-outcomes-of-osteosynthesis-using-proximal-femoral-nail-antirotation-pfna-system-in-intertrochanteric-femoral-fracture-has-pfna-ii-solved-all-the-problems
#5
Won Chul Shin, Jung Dong Seo, Sang Min Lee, Nam Hoon Moon, Jung Sub Lee, Kuen Tak Suh
PURPOSE: We evaluated the geometric discrepancies between the proximal femur in Koreans and two types of proximal femoral nail using plain radiographs. MATERIALS AND METHODS: A total of 100 consecutive patients (38 treated with proximal femoral nail antirotation [PFNA], 62 PFNA II) with intertrochanteric fracture were retrospectively identified. The minimum follow up period was 32 months. The geometric analysis of the proximal femur was performed using preoperative true hip antero-posterior radiographs of the unaffected side, and the data were compared with the PFNA and PFNA II dimensions...
June 2017: Hip & Pelvis
https://www.readbyqxmd.com/read/28551834/increased-bone-tracer-uptake-in-symptomatic-patients-with-acl-graft-insufficiency-a-correlation-of-mri-and-spect-ct-findings
#6
Dominic T Mathis, Anna Hirschmann, Anna L Falkowski, Tommi Kiekara, Felix Amsler, Helmut Rasch, Michael T Hirschmann
PURPOSE: Magnetic resonance imaging (MRI) and single-photon emission computerised tomography/computerised tomography (SPECT/CT) are used as diagnostic tools in symptomatic patients after reconstruction of the anterior cruciate ligament (ACL). The benefit of SPECT/CT in comparison with MRI is under debate. The purpose of this study was to investigate whether and how bone tracer uptake (BTU) intensity and distribution in SPECT/CT correlate with MRI findings in symptomatic patients after ACL reconstruction...
May 27, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28547675/complications-following-proximal-femoral-locking-compression-plating-in-unstable-proximal-femur-fractures-medium-term-follow-up
#7
Sandro Hodel, Frank J P Beeres, Reto Babst, Björn-Christian Link
PURPOSE: To assess the outcome in patients treated with proximal femoral locking compression plate (PF-LCP 4.5/5.0, Synthes(©)) for unstable inter- and subtrochanteric femoral fractures. METHODS: A retrospective analysis of 16 patients with proximal femur fractures (AO: 31A2: n = 5/32.3%; 31-A3: n = 10/62.5%; 32B1: n = 1/6.3%) treated with a PF-LCP at a Level 1 trauma centre between 2011 and 2015 was conducted. RESULTS: Sixteen patients were available for follow-up with a mean follow-up time of 14 months (range 4-29)...
May 25, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28529662/femoral-and-acetabular-re-alignment-in-slipped-capital-femoral-epiphysis
#8
M Leunig, H M Manner, L Turchetto, R Ganz
NEW PATHOPHYSIOLOGICAL INSIGHTS: Based on improved knowledge of the vascular supply of the proximal femur, a safe surgical dislocation of the hip joint was established allowing direct insights to the pathomorphological malfunctioning of the joint. One insight was that slipped capital femoral epiphysis (SCFE) impingement leads to substantial damage of the chondrolabral rim area, even in the presence of minor slips. A further surgical development was the extended retinacular flap allowing for correction of the deformity with calculable risk for iatrogenic necrosis...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28513428/slipped-capital-femoral-epiphysis-a-review-of-management-in-the-hip-impingement-era
#9
Mahmoud A Mahran, Mostafa M Baraka, Hany M Hefny
Slipped capital femoral epiphysis (SCFE) remains the most common adolescent hip disorder. Most cases present with stable slips, and in situ fixation is the most commonly adopted treatment worldwide. The introduction of the concept of femoroacetabular impingement and subsequent studies have revealed SCFE-related hip impingement to be a significant pre-arthritic condition, and the previously suggested remodeling of the proximal femur after in situ fixation has been called into question. Complex proximal femoral osteotomies and more recently intra-articular procedures via surgical hip dislocation have been employed...
2017: SICOT-J
https://www.readbyqxmd.com/read/28373141/spine-hip-relations-add-understandings-to-the-pathophysiology-of-femoro-acetabular-impingement-a-systematic-review
#10
REVIEW
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
https://www.readbyqxmd.com/read/28363893/osseous-impingement-occurs-early-in-flexion-in-cam-type-femoroacetabular-impingement-a-4d-ct-model
#11
S Fernquest, C Arnold, A Palmer, J Broomfield, J Denton, A Taylor, S Glyn-Jones
AIMS: The aim of this study was to examine the real time in vivo kinematics of the hip in patients with cam-type femoroacetabular impingement (FAI). PATIENTS AND METHODS: A total of 50 patients (83 hips) underwent 4D dynamic CT scanning of the hip, producing real time osseous models of the pelvis and femur being moved through flexion, adduction, and internal rotation. The location and size of the cam deformity and its relationship to the angle of flexion of the hip and pelvic tilt, and the position of impingement were recorded...
April 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28353567/are-normal-hips-being-labeled-as-femoroacetabular-impingement-due-to-ee-angle
#12
Tian You, Bei Yang, Xin-Tao Zhang, Xiao-Cheng Jiang, Shuang Wang, Wen-Tao Zhang
Gluteal muscle contracture (GMC) is a clinical syndrome characterized by gait abnormality and limb dysfunction, as well as secondary deformities of pelvis and femur. Femoroacetabular impingement (FAI) typically could be diagnosed on the basis of computed tomography (CT) such as the equatorial-edge angle (EE angle), but it did not work well in GMC patients. In this study, we retrospected all image data and found small EE angles in GMCs, which meant retroverted acetabulum; however, none of them showed no symptoms and signs of FAI...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28349206/impingement-of-the-patellar-component-against-the-tibial-post-after-posterior-stabilized-and-constrained-tka-a-pilot-study
#13
Yukihide Minoda, Ryo Sugama, Yoichi Ohta, Hiroaki Nakamura
INTRODUCTION: Patella-post impingement (PPI), contact of the patellar component with the tibial post, occurs during deep knee flexion after posterior stabilized total knee arthroplasty (TKA). PPI can cause anterior knee pain, increased patellar pressure, wear of the polyethylene patellar component and tibial post, and poor range of motion. There have been no reports on the relationship between PPI and tibial post design. The aim of this study was to compare different tibial post designs with regard to PPI incidence...
March 27, 2017: Archives of Orthopaedic and Trauma Surgery
https://www.readbyqxmd.com/read/28342138/does-removal-of-subchondral-cortical-bone-provide-sufficient-resection-depth-for-treatment-of-cam-femoroacetabular-impingement
#14
Penny R Atkins, Stephen K Aoki, Ross T Whitaker, Jeffrey A Weiss, Christopher L Peters, Andrew E Anderson
BACKGROUND: Residual impingement resulting from insufficient resection of bone during the index femoroplasty is the most-common reason for revision surgery in patients with cam-type femoroacetabular impingement (FAI). Development of surgical resection guidelines therefore could reduce the number of patients with persistent pain and reduced ROM after femoroplasty. QUESTIONS/PURPOSES: We asked whether removal of subchondral cortical bone in the region of the lesion in patients with cam FAI could restore femoral anatomy to that of screened control subjects...
August 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28334547/origin-of-cam-morphology-in-femoroacetabular-impingement
#15
William Z Morris, Ryan T Li, Raymond W Liu, Michael J Salata, James E Voos
Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity...
March 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28244926/biomechanical-evaluation-of-the-depth-of-resection-during-femoral-neck-osteoplasty-for-anterior-impingement-following-slipped-capital-femoral-epiphysis
#16
Kevin M Dale, Geoffrey T Burns, Ying Li
BACKGROUND: Femoroacetabular impingement as a result of slipped capital femoral epiphysis (SCFE) has been treated traditionally with a proximal femoral osteotomy, but open and arthroscopic femoral osteoplasty is becoming increasingly popular. Cam lesions result from excess bone primarily at the anterolateral femoral head-neck junction. SCFEs result from posterior and inferior slippage of the femoral epiphysis, causing the metaphysis to move anteriorly. This study's purpose was to compare fourth-generation sawbones standard femurs with SCFE femurs to determine whether bone resection from the anterior metaphysis results in similar biomechanical properties...
February 27, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28229355/femoral-shaft-osteotomy-for-obligate-outward-rotation-due-to-scfe
#17
Peter M Stevens, Lucas Anderson, Bruce A MacWilliams
Slipped capital femoral epiphysis (SCFE) is an adolescent disease that leads to retroversion of the femoral neck and shaft, relative to the head. Observing that patients with SCFE must walk with an outward foot progression angle and externally rotate the leg in order to flex the hip, we have been performing a femoral shaft rotational osteotomy wherein we rotate the lower femur 45° inward, relative to the upper femur. By correcting retroversion, our goal is to improve functional hip and knee motion, thereby mitigating the effects of SCFE impingement...
April 2017: Strategies in Trauma and Limb Reconstruction
https://www.readbyqxmd.com/read/28194709/high-survivorship-and-little-osteoarthritis-at-10-year-followup-in-scfe-patients-treated-with-a-modified-dunn-procedure
#18
Kai Ziebarth, Milan Milosevic, Till D Lerch, Simon D Steppacher, Theddy Slongo, Klaus A Siebenrock
BACKGROUND: The modified Dunn procedure has the potential to restore the anatomy in hips with slipped capital femoral epiphyses (SCFE) while protecting the blood supply to the femoral head and minimizing secondary impingement deformities. However, there is controversy about the risks associated with the procedure and mid- to long-term data on clinical outcomes, reoperations, and complications are sparse. QUESTIONS/PURPOSES: Among patients treated with a modified Dunn procedure for SCFE, we report on (1) hip pain and function as measured by the Merle d'Aubigné and Postel score, Drehmann sign, anterior impingement test, limp, and ROM; (2) the cumulative survivorship at minimum 10-year followup with endpoints of osteoarthritis (OA) progression (at least one Tönnis grade), subsequent THA, or a Merle d'Aubigné and Postel score < 15; (3) radiographic anatomy of the proximal femur measured by slip angle, α angle, Klein line, and sphericity index; and (4) the risk of subsequent surgery and complications...
April 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28176673/surgical-hip-dislocation-in-treatment-of-slipped-capital-femoral-epiphysis
#19
Mohammed Elmarghany, Tarek M Abd El-Ghaffar, Mahmoud Seddik, Ahmed Akar, Yousef Gad, Eissa Ragheb, Alessandro Aprato, Alessandro Massè
BACKGROUND: Most surgeons advocate in situ fixation of the slipped epiphysis with acceptance of any persistent deformity in the proximal femur [Aronsson DD, Loder RT, Breur GJ, Weinstein SL (2006) Slipped capital femoral epiphysis: current concepts. J Am Acad Orthop Surg 14, 666-679]. This residual deformity can lead to osteoarthritis due to femoroacetabular cam impingement (FAI) [Leunig M, Slongo T, Ganz R (2008) Subcapital realignment in slipped capital femoral epiphysis: surgical hip dislocation and trimming of the stable trochanter to protect the perfusion of the epiphysis...
2017: SICOT-J
https://www.readbyqxmd.com/read/28165597/increase-in-safe-zone-area-of-the-acetabular-cup-using-dual-mobility-cups-in-tha
#20
Takaaki Ohmori, Tamon Kabata, Toru Maeda, Yoshitomo Kajino, Tadashi Taga, Kazuhiro Hasegawa, Daisuke Inoue, Takashi Yamamoto, Tomoharu Takagi, Hiroyuki Tsuchiya
BACKGROUND: Dual mobility cup (DMC) inserts reduce the risk of dislocation after total hip arthroplasty (THA). No available research has clearly delineated stability advantages of DMC inserts in primary and revision THA. We investigated: (i) the degree of change in the safe zone of the cup when a DMC insert is used compared to a fixed insert; (ii) the method of selecting candidates for a DMC insert without changing the position of the acetabular (cup) component during revision THA in frequent dislocation cases caused by implant impingement...
January 30, 2017: Hip International: the Journal of Clinical and Experimental Research on Hip Pathology and Therapy
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