Femoroacetabular impingement (FAI) causes abnormal contact at the anterosuperior aspect of the acetabulum in activities requiring a large hip range of motion (ROM). We addressed the following questions in this study: (1) Does FAI affect the motions of the hip and pelvis during a maximal depth squat? (2) Does FAI decrease maximal normalized squat depth? We measured the effect of cam FAI on the 3-D motion of the hip and pelvis during a maximal depth squat as compared with a healthy control group. Fifteen participants diagnosed with cam FAI and 11 matched control participants performed unloaded squats while 3-D motion analysis was collected. Patients with FAI had no differences in hip motion during squatting but had decreased sagittal pelvic range of motion compared to the control group (14.7 ± 8.4°versus 24.2 ± 6.8°, respectively). The FAI group also could not squat as low as the control group (41.5 ± 12.5% versus 32.3 ± 6.8% of leg length, respectively), indicating the maximal depth squat may be useful as a diagnostic exercise. Limited sagittal pelvic ROM in FAI patients may contribute to their decreased squatting depth, and could represent a factor amongst others in the pathomechanics of FAI. Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
The mechanism of anterior cruciate ligament (ACL) injury is still unclear. To gain this insight, knowledge of the mechanical behaviour of the healthy ACL during activities that may stress the ligament must be investigated in vivo. The goal of this research was to measure ACL strain in vivo during rapid deceleration, a sport type movement that has been previously shown to precede injuries to the ACL in healthy subjects. A young male subject with no previous knee joint injuries volunteered after informed consent. The strain gauge device (DVRT) was calibrated and surgically implanted in the antero-medial band of the intact ACL. The subject was then transported to the lab for data collection. The zero strain position of the ACL was determined using the slack-taut technique. The subject hopped as quickly as possible from a distance of 1.5 m to the target, an X taped at the centre of a force plate, landing with the instrumented left leg and stopping in the landed position. The entire collection window was five seconds at 1000 Hz. A total of three rapid deceleration trials were collected and averaged over the hop cycle. The slack-taut test was then repeated to ensure proper operation of the DVRT and the reliability of the results. The results showed an average peak strain of the ACL during the instrumented Lachman test of 2.00+/-0.17%. The average peak strain of the ACL during the rapid deceleration task was 5.47+/-0.28%. The data indicate that the RD task caused an increase in peak ACL strain that is much higher than during the instrumented Lachman test, and that the strain begins to increase during the flight phase, prior to landing, and reaches a peak that corresponds to the peak ground reaction force. This technique may be used in further sport-specific movements to gain insight into movement patterns associated with ACL injury mechanisms.
Background Femoroacetabular impingement (FAI) represents a constellation of anatomical and clinical features, but definitive diagnosis is often difficult. The high prevalence of cam deformity of the femoral head in the asymptomatic population as well as clinical factors leading to the onset of symptoms raises questions as to what other factors increase the risk of cartilage damage and hip pain.Questions/purposes The purpose was to identify any differences in anatomical parameters and squat kinematics among symptomatic, asymptomatic, and control individuals and if these parameters can determine individuals at risk of developing symptoms of cam FAI. Methods Forty-three participants (n = 43) were recruited and divided into three groups: symptomatic (12), asymptomatic (17), and control (14). Symptomatic participants presented a cam deformity (identified by an elevated alpha angle on CT images), pain symptoms, clinical signs, and were scheduled for surgery. The other recruited volunteers were blinded and unaware whether they had a cam deformity. After the CT data were assessed for an elevated alpha angle, participants with a cam deformity but who did not demonstrate any clinical signs or symptoms were considered asymptomatic, whereas participants without a cam deformity and without clinical signs or symptoms were considered healthy control subjects. For each participant, anatomical CT parameters (axial alpha angle, radial alpha angle, femoral head-neck offset, femoral neck-shaft angle, medial proximal femoral angle, femoral torsion, acetabular version) were evaluated. Functional squat parameters (maximal squat depth, pelvic range of motion) were determined using a motion capture system. A stepwise discriminant function analysis was used to determine
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