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Femural impingement

José Batista Volpon
The femoroacetabular impingement (FAI) is as condition recently characterized that results from the abnormal anatomic and functional relation between the proximal femur and the acetabular border, associated with repetitive movements, which lead labrum and acetabular cartilage injuries. Such alterations result from anatomical variations such as acetabular retroversion or decrease of the femoroacetabular offset. In addition, FAI may result from acquired conditions as malunited femoral neck fractures, or retroverted acetabulum after pelvic osteotomies...
November 2016: Revista Brasileira de Ortopedia
Hiroshi Imai, Joji Miyawaki, Tomomi Kamada, Akira Maruishi, Jun Takeba, Hiromasa Miura
BACKGROUND: In order to prevent postoperative dislocation due to prosthetic impingement as a result of total hip arthroplasty (THA), the combined anteversion (CA) theory, which combines the anteversion of the femoral stem and the acetabular socket, has been revised in recent years. Particularly, it is necessary to keep CA within the target zone. METHODS: The aim of this study was to investigate whether postoperative CA can be kept within the target zone while using the operative technique which prepares the socket first in cementless THA, by estimating the anteversion of the metaphyseal fit stem or the shorter, tapered wedge stem using preoperative 3-dimensional computerized planning, and by adjusting the anteversion of the socket using a navigation system that considers CA...
November 10, 2016: Journal of Arthroplasty
Russell J Coppack, James L Bilzon, Andrew K Wills, Ian M McCurdie, Laura Partridge, Alastair M Nicol, Alexander N Bennett
BACKGROUND: Non-arthritic hip disorders are defined as abnormalities of the articulating surfaces of the acetabulum and femur before the onset of osteoarthritis, including intra-articular structures such as the acetabular labrum and chondral surfaces. Abnormal femoroacetabular morphology is commonly seen in young men who constitute much of the UK military population. Residential multidisciplinary team (MDT) rehabilitation for patients with musculoskeletal injuries has a long tradition in the UK military, however, there are no studies presenting empirical data on the efficacy of a residential MDT approach compared with individualised conventional outpatient treatment...
November 8, 2016: BMC Musculoskeletal Disorders
Anthony C Egger, Salvatore Frangiamore, James Rosneck
Femoroacetabular impingement (FAI) is one of the most researched conditions in sports medicine today. FAI occurs due to abnormal morphology and subsequently contact between the proximal femur and the acetabulum. With repetitive loading, this femoroacetabular mismatch can be a source of labral and chondral injuries. FAI is more prevalent in the athletic population, particularly those athletes who participated in high level activities at a younger age. If nonoperative management is failed, surgical treatment is often done arthroscopically and with good results...
December 2016: Sports Medicine and Arthroscopy Review
Penny R Atkins, Shireen Y Elhabian, Praful Agrawal, Michael D Harris, Ross T Whitaker, Jeffrey A Weiss, Christopher L Peters, Andrew E Anderson
: The proximal femur is abnormally shaped in patients with cam-type femoroacetabular impingement (FAI). Impingement may elicit bone remodeling at the proximal femur, causing increases in cortical bone thickness. We used correspondence-based shape modeling to quantify and compare cortical thickness between cam patients and controls for the location of the cam lesion and the proximal femur. Computed tomography images were segmented for 45 controls and 28 cam-type FAI patients. The segmentations were input to a correspondence-based shape model to identify the region of the cam lesion...
October 27, 2016: Journal of Orthopaedic Research: Official Publication of the Orthopaedic Research Society
Michel P Bonnin, Arnoud de Kok, Matthias Verstraete, Tom Van Hoof, Catherine Van der Straten, Mo Saffarini, Jan Victor
PURPOSE: To determine the mechanisms and extents of popliteus impingements before and after TKA and to investigate the influence of implant sizing. The hypotheses were that (1) popliteus impingements after TKA may occur at both the tibia and the femur, and (2) even with an apparently well-sized prosthesis, popliteal tracking during knee flexion is modified compared to the preoperative situation. METHODS: The location of the popliteus in three cadaver knees was measured using computed tomography, before and after implantation of plastic TKA replicas, by injecting the tendon with radiopaque liquid...
September 26, 2016: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
W Z Morris, C A Fowers, R T Yuh, J J Gebhart, M J Salata, R W Liu
OBJECTIVES: The spinopelvic relationship (including pelvic incidence) has been shown to influence pelvic orientation, but its potential association with femoroacetabular impingement has not been thoroughly explored. The purpose of this study was to prove the hypothesis that decreasing pelvic incidence is associated with increased risk of cam morphology. METHODS: Two matching cohorts were created from a collection of cadaveric specimens with known pelvic incidences: 50 subjects with the highest pelvic incidence (all subjects > 60°) and 50 subjects with the lowest pelvic incidence (all subjects < 35°)...
September 2016: Bone & Joint Research
Michael Worlicek, Markus Weber, Benjamin Craiovan, Michael Wörner, Florian Völlner, Hans R Springorum, Joachim Grifka, Tobias Renkawitz
BACKROUND: Improper femoral and acetabular component positioning can be associated with instability, impingement, component wear and finally patient dissatisfaction in total hip arthroplasty (THA). The concept of "femur first"/"combined anteversion", incorporates various aspects of performing a functional optimization of the prosthetic stem and cup position of the stem relative to the cup intraoperatively. In the present study we asked two questions: (1) Do native femoral anteversion and anteversion of the implant correlate? (2) Do anteversion of the final broach and implant anteversion correlate? METHODS: In a secondary analysis of a prospective controlled trial, a subgroup of 55 patients, who underwent computer-assisted, cementless THA with a straight, tapered stem through an anterolateral, minimally invasive (MIS) approach in a lateral decubitus position were examined retrospectivly...
September 20, 2016: BMC Musculoskeletal Disorders
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
Ghislain Maquer, Alexander Bürki, Katja Nuss, Philippe K Zysset, Moritz Tannast
BACKGROUND: Osteochondroplasty of the head-neck region is performed on patients with cam femoroacetabular impingement (FAI) without fully understanding its repercussion on the integrity of the femur. Cam-type FAI can be surgically and reproducibly induced in the ovine femur, which makes it suitable for studying corrective surgery in a consistent way. Finite element models built on quantitative CT (QCT) are computer tools that can be used to predict femoral strength and evaluate the mechanical effect of surgical correction...
December 2016: Clinical Orthopaedics and related Research
Weverley Rubele Valenza, Jamil Faissal Soni, Christiano Saliba Uliana, Fernando Ferraz Faria, Gisele Cristine Schelle, Daniel Sakamoto Sugisawa
OBJECTIVE: To present our experience and preliminary results from using controlled hip dislocation to treat cam-like femoroacetabular impingement, in teenagers and young adults with sequelae of slipped capital femoral epiphysis. METHODS: This was a retrospective analysis on 15 patients who were treated in a tertiary-level hospital between 2011 and 2013. The following data were collected for analysis from these patients' files: demographic data, surgical procedure reports, joint mobility evaluations, patients' perceptions regarding clinical improvement and whether they would choose to undergo the operation again, previous hip surgery and complications...
July 2016: Revista Brasileira de Ortopedia
Taesoo Ahn, Chul-Ho Kim, Tae Hyung Kim, Jae Suk Chang, Mi Yeon Jeong, Kekatpure Aditya, Pil Whan Yoon
BACKGROUND: Morphologic features of the proximal femur reminiscent of those seen in patients with femoroacetabular impingement (FAI) have been reported among asymptomatic individuals in Western populations, but whether this is the case in Asian populations is unknown. QUESTIONS/PURPOSES: The purpose of this study was to determine the prevalence of radiographic findings in the proximal femur that are consistent with FAI in asymptomatic Korean volunteers. METHODS: Two hundred asymptomatic volunteers with no prior hip surgery or childhood hip problems underwent three-view plain radiographs (pelvis AP view, Sugioka view, and 45° Dunn view) of both hips...
December 2016: Clinical Orthopaedics and related Research
Lena Hirtler, Sebastian Röhrich, Franz Kainberger
OBJECTIVE: The goals of this study were to test whether age- and sex-dependent variations in the size and shape of the intercondylar notch exist and to define the landmarks and measurements best suited for assessment of the intercondylar notch on MR images. MATERIALS AND METHODS: In this retrospective cross-sectional study, 329 patients were divided into six age groups, and their MR images (3-T coronal T2-weighted fat-suppressed spectral attenuated inversion recovery [SPAIR], sagittal proton density-weighted, axial T2-weighted fat-suppressed SPAIR) were evaluated...
August 4, 2016: AJR. American Journal of Roentgenology
Stephen M Mann, Manuela Kunz, Randy E Ellis, John F Rudan
BACKGROUND: Metal ion levels are used as a surrogate marker for wear in hip resurfacing arthroplasties. Improper component position, particularly on the acetabular side, plays an important role in problems with the bearing surfaces, such as edge loading, impingement on the acetabular component rim, lack of fluid-film lubrication, and acetabular component deformation. There are little data regarding femoral component position and its possible implications on wear and failure rates. The purpose of this investigation was to determine both femoral and acetabular component positions in our cohort of mechanically stable hip resurfacing arthroplasties and to determine if these were related to metal ion levels...
January 2017: Journal of Arthroplasty
F Schmaranzer, M Hanke, T Lerch, S Steppacher, K Siebenrock, M Tannast
Femoroacetabular impingement (FAI) describes the repetitive painful contact between the acetabulum, the pelvis and the proximal femur. This bony abutment can lead to a characteristic pattern of chondrolabral damage and is one of the main etiological factors in the development of juvenile osteoarthritis of the hip joint. This article describes the current treatment concepts of FAI and the radiological assessment including an overview of standard measurement methods, coxometric parameters and cut-off values. Furthermore, the authors stress the importance of a profound understanding of the entire configuration of the pelvis and the dynamic interplay of its components...
September 2016: Der Radiologe
Omar R Peña, Amparo Gómez Gélvez, Kristian A Espinosa
BACKGROUND: Cortical impingement is a common complication after cephalomedullary nailing, but the evidence about its consequences is very limited. The aim of this study was to assess the clinical implications of cortical impingement on patients treated with cephalomedullary nails. METHODS: A cohort study was carried out at a Level I academic Institution with consecutive patients treated with cephalomedullary nails during 2010 and 2013. Demographic and nail variables were recorded as well as cortical impingement was determined on the radiographs...
June 21, 2016: Injury
Brian C Werner, Michael A Gaudiani, Anil S Ranawat
Cam-type deformity of the proximal femur is a relative increase in the discrepancy of the femoral head-neck offset. The etiology is unknown; several conditions have been implicated in the development of abnormal proximal femoral anatomy. Recent evidence suggests that high-impact sports place stress on the immature physis during growth and may play an important role. Imaging is essential in the initial diagnostic workup, characterization of pathology, preoperative planning, and intraoperative decision making...
July 2016: Clinics in Sports Medicine
Yoon Je Cho, Gwang Young Jung, Eung Ju Kim, Young Soo Chun, Kee Hyung Rhyu
Cam-type femoroacetabular impingement is a pathologic condition caused by repetitive impact of the abnormal femur on a normal acetabular rim, resulting in damage to the articular cartilage. Excluding cases with known underlying diseases, the development of primary cam deformity is not well understood. Here, we describe a patient with cam-type femoroacetabular impingement exhibiting delayed epiphyseal closure at the site of the cam lesion. The authors believe that this may represent a cause of primary cam deformity, and hereby report the case with review of the literature...
September 2016: Skeletal Radiology
Markus Weber, Michael L Woerner, Ernst Sendtner, Florian Völlner, Joachim Grifka, Tobias F Renkawitz
BACKGROUND: In this prospective study of 66 patients undergoing cementless total hip arthroplasty through a minimally invasive anterolateral approach, we evaluated the impact of an intraoperative hybrid combined anteversion technique on postoperative range of motion (ROM). METHODS: After navigation of femoral stem anteversion, trial acetabular components were positioned manually, and their position recorded with navigation. Then, final components were implanted with navigation at the goals prescribed by the femur-first impingement detection algorithm...
April 30, 2016: Journal of Arthroplasty
Ran Thein, Elad Spitzer, John Doyle, Saker Khamaisy, Danyal H Nawabi, Harshvardhan Chawla, Joseph D Lipman, Andrew D Pearle
BACKGROUND: Impingement of anterior cruciate ligament (ACL) grafts against the femoral notch and the posterior cruciate ligament (PCL) is thought to be influenced primarily by tunnel position and graft orientation. Recent data have implied that the native ACL is ribbon-shaped. PURPOSE: To evaluate the 3-dimensional shape and cross-sectional area of the native ACL versus the ACL graft and to compare the degree of impingement against the femoral notch and PCL. STUDY DESIGN: Cross-sectional study; Level of evidence, 3...
August 2016: American Journal of Sports Medicine
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