Tratamento artroscópico do impacto femoroacetabular

Polesello, Giancarlo Cavalli; Queiroz, Marcelo Cavalheiro de; Ono, Nelson Keiske; Honda, Emerson Kiyoshi; Guimarães, Rodrigo Pereira; Junior, Walter Ricioli

doi:10.1590/s0102-36162009000300009

Cited by 13 publications

(5 citation statements)

References 32 publications

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“…Limitation of internal rotation is a common sign of FAI morphology related to abnormal stresses in the proximal femur [17,18]. In their sample of patients who underwent arthroscopic repair of FAI, Polesello et al presented a cohort with 100% of the cases displaying lower internal rotation degrees (IR) in the preoperative evaluation [22]. In another study, Hopkinson et al suggest that the mechanism of extra-articular fractures of the proximal femur is related to torsional forces during a fall [21].…”

Section: Discussionmentioning

confidence: 99%

“…Considering that the mechanism of torsional trauma has been implicated in the genesis of extra-capsular fractures of the hip [21] and that patients with FAI generally present a decrease in hip internal rotation [22,23], it is fair to propose that the reduction in the range of motion, associated with a traumatic torsional force, could cause a sudden increase of stresses in the proximal femur, leading to a higher risk of fracture, especially on elderly patients with FAI morphology. The proposed mechanism is illustrated in Figure 1.…”

Section: Introductionmentioning

confidence: 99%

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Increased prevalence of femoroacetabular impingement on the elderly with fractures of the proximal femur

Busato¹,

Baggio²,

Morozowski³

et al. 2021

SICOT-J

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Objectives: Femoroacetabular impingement (FAI) has been recently related to several pathologies, besides chondral injury and hip arthritis. We aim to investigate the prevalence of FAI morphology in an elderly cohort hospitalized due to a proximal femur fracture and compare these findings to a control group. We hypothesize that limited medial rotation due to FAI’s morphology could increase stresses to the proximal femur, acting as a facilitating mechanism for fractures in this region. Therefore, a higher prevalence of FAI morphology would be present in the study group. Methods: A retrospective cross-sectional study was performed based on the analysis of radiographic images in AP and lateral views of the fractured hip. Firstly, we have set to measure FAI prevalence in an elderly cohort victimized by fractures of the proximal by measures of the alpha, Tönnis, and lateral center edge angles of a hundred consecutive patients hospitalized for proximal femur fractures. Secondly, we have analyzed the possible relationship between the FAI subtypes and the type of fracture. Finally, we have compared this sample’s data with that of a similar control cohort not affected by fracture. Results: The cohort in this study displayed a higher prevalence of pathological changes in the Tönnis, center-edge, and alpha angles with odds ratios of 3.41, 2.56, and 4.80, respectively (with statistical significance). There was also a significant relationship between cam-type FAI and intertrochanteric fractures, corroborating our initial hypotheses. Conclusions: This study demonstrated that a cohort of older patients affected by fractures of the proximal femur had an increased prevalence of radiographic signs of femoroacetabular impingement. Furthermore, this is the first study demonstrating a statistically significant relationship of cam-type FAI with intertrochanteric fractures, suggesting a possible cause and effect relationship.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Increased prevalence of femoroacetabular impingement on the elderly with fractures of the proximal femur

Busato¹,

Baggio²,

Morozowski³

et al. 2021

SICOT-J

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“…In this view we can also clearly observe the anterosuperior segment of the femoral head-neck transition; and It is also possible to measure the alpha angle in both views (angle formed between the longitudinal axis of the femoral neck and a line passing through the center of rotation of the femoral head and through the point of the head-neck junction from where the distance to the center of the head exceeds the radius, i.e., loses sphericity. Its normal value should not exceed 55°) 3 , 12 , 13 ( Figure 9 ). Arcelin's surgical profile or cross table view: Patient in supine position with flexion of 90 degrees of the contralateral hip; The X-ray tube should be angled 45° cranially in the horizontal plan, towards the thigh root (does not require mobilization of the affected hip, and is ideal for traumatized patients) ( Figure 10 ); and Observe the femoral neck in profile and the head-neck transition.…”

Section: Radiographic Viewsmentioning

confidence: 99%

Section: Radiographic Viewsmentioning

confidence: 99%

Proposal for Standardization of Radiographic Studies on the Hip and Pelvis

Polesello

Nakao

Queiroz

et al. 2011

Revista Brasileira de Ortopedia (English Edition)

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Diagnoses of hip and pelvis disorders are based on the detailed medical history, physical examination and laboratory tests, as appropriate for each condition. Plain radiography is still the initial examination of choice and, because of its importance, there is a need to standardize radiographic studies, both in relation to execution and in radiographic series, according to the different pathological conditions. The aim of this paper was to propose standardization for the main radiographic views of the hip and pelvis, and with regard to performing specific series for different pathological conditions, and to provide technical guidance for achieving these aims.

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“…In this view we can also clearly observe the anterosuperior segment of the femoral head-neck transition; and -It is also possible to measure the alpha angle in both views (angle formed between the longitudinal axis of the femoral neck and a line passing through the center of rotation of the femoral head and through the point of the head-neck junction from where the distance to the center of the head exceeds the radius, i.e., loses sphericity. Its normal value should not exceed 55°) (3,12,13) (Figure 9). Given the superimposition of images on the femoral side and on the acetabular side, it is the same as a frontal pelvic radiograph, and its usefulness in adults is questionable.…”

Section: Introductionmentioning

confidence: 99%