Anatomic Predictors of Sagittal Hip and Pelvic Motions in Patients With a Cam Deformity

Ng, K. C. Geoffrey; Lamontagne, Mario; Jeffers, Jonathan R.T.; Grammatopoulos, George; Beaulé, Paul E.

doi:10.1177/0363546518755150

Cited by 45 publications

(53 citation statements)

References 62 publications

(129 reference statements)

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“…Lastly, the role that dynamic spinopelvic kinematics play in impingement and resulting symptoms was only recently explored. 113,114 Regarding acetabular-based deformities that lead to impingement (i.e., pincer), thinking has evolved. 3 The classic example of pincer impingement is acetabular protrusio where overcoverage is defined on the AP pelvic radiograph as the femoral head touching and/or crossing the ilioischial line.…”

Section: Impingementmentioning

confidence: 99%

Femoroacetabular Impingement: What the Surgeon Wants to Know

Rego

Beaulé

Ayeni

et al. 2019

Semin Musculoskelet Radiol

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Femoroacetabular impingement (FAI) is increasingly recognized as a risk factor for early hip degeneration in young active patients. The diagnosis depends on clinical examination and proper imaging that should be able to identify abnormal and sometimes subtle morphological changes. Labral tears and cartilage lesions rarely occur without underlying bone abnormalities. Surgical approaches to treat FAI are increasing significantly worldwide, even without a clearly defined consensus of what should be accepted as the standard imaging diagnosis for FAI morphology.Hip abnormalities encompass many variations related to the shape, size, and spatial orientation of both sides of the joint and can be difficult to characterize if adequate imaging is not available.This article presents a comprehensive review about the information orthopaedic surgeons need to know from radiologists to plan the most rational approach to a painful hip resulting from a mechanical abnormality.

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Section: Impingementmentioning

confidence: 99%

Femoroacetabular Impingement: What the Surgeon Wants to Know

Rego

Beaulé

Ayeni

et al. 2019

Semin Musculoskelet Radiol

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“…The hip-spine biomechanics, morphological abnormalities like dysplasia and FAI and also abnormalities of pelvic motion have a major impact on the functioning of the Iliopsoas [25,26].…”

Section: Discussionmentioning

confidence: 99%

Anatomical variation of the Psoas Valley: a scoping review

Kuroda

Rai

Saito

et al. 2020

BMC Musculoskelet Disord

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Background: This scoping review aimed to investigate the literature on the anatomy of the psoas valley, an anterior depression on the acetabular rim, and propose a unified definition of the anatomical structure, describe its dimensions, anatomical variations and clinical implications. Methods: A systematic computer search of EMBASE, PubMed and Cochrane for literature related to the psoas valley was undertaken using Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Clinical outcome studies, prospective/retrospective case series, case reports and review articles that described the psoas valley and its synonyms were included. Studies on animals as well as book chapters were excluded. Results: Of the 313 articles, the filtered literature search identified 14 papers describing the psoas valley and its synonyms such as iliopsoas notch, a notch between anterior inferior iliac spine and the iliopubic eminence, Psoas-U and anterior wall depression. Most of these were cross-sectional studies that mainly analyzed normal skeletal hips. In terms of anatomical variation, 4 different configurations of the anterior acetabular rim have been identified and it was found that the curved type was the most frequent while the straight type may be nonexistent. Additionally, the psoas valley tended to be deeper in males as compared with females. Several papers established the psoas valley, or Psoas-U in a consistent location at approximately 3 o'clock on the acetabular rim which may have implications with labral pathology. Conclusion: This review highlights the importance of the anatomy of the psoas valley which is a consistent bony landmark. The anatomy and the anatomical variations of the psoas valley need to be well-appreciated by surgeons involved in the management of young adults with hip pathology and also joint replacement surgeons to ensure appropriate seating of the acetabular component.

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“…The study quantified the contribution of the cam deformity, which accounted for 21% to 27% of the torsional loading of the intact hip in deep flexion and internal rotation (Fig. 6), where the specimens indicated secondary at-risk parameters of smaller femoral neck-shaft [67][68][69][70][71] and higher spinopelvic incidence angles [72][73][74] . Capsular repairs restrained external rotation during deep flexion and were ineffective in other testing positions, partly because of the inherently large native head that maintained joint stability and partly because the cam deformities were not overresected (i.e., no proximal concavity or "cookie bite").…”

Section: Effects Of Hip Preservation Surgerymentioning

confidence: 99%

Hip Joint Capsular Anatomy, Mechanics, and Surgical Management

Jeffers

Beaulé

2019

The Journal of Bone and Joint Surgery

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ä Hip joint capsular ligaments (iliofemoral, ischiofemoral, and pubofemoral) play a predominant role in functional mobility and joint stability. ä The zona orbicularis resists joint distraction (during neutral positions), and its aperture mechanism stabilizes the hip from adverse edge-loading (during extreme hip flexion-extension). ä To preserve joint function and stability, it is important to minimize capsulotomy size and avoid disrupting the zona orbicularis, preserve the femoral head size and neck length, and only repair when or as necessary without altering capsular tensions. ä It is not fully understood what the role of capsular tightness is in patients who have cam femoroacetabular impingement and if partial capsular release could be beneficial and/or therapeutic. ä During arthroplasty surgery, a femoral head implant that is nearly equivalent to the native head size with an optimal neck-length offset can optimize capsular tension and decrease dislocation risk where an intact posterior hip capsule plays a critical role in maintaining hip stability. Characteristics Anatomy Human ligaments consist of predominantly type-I collagen (85%) and combinations of type III, V, VI, XI, and XIV (15%) 21,22. Within the hip joint, higher ratios of type-III collagen in the ligamentous capsule are associated with hip instability 23,24 , whereas elevated levels in the cartilage are associated with Disclosure: The authors indicated grant support from the Engineering and Physical Sciences Research Council (EPSRC) (EP/K027549/1 and EP/ N006267/1) and the Wellcome Trust (088844/Z/09/Z), during the conduct of the study. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked "yes" to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/F511).

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Anatomic Predictors of Sagittal Hip and Pelvic Motions in Patients With a Cam Deformity

Cited by 45 publications

References 62 publications

Femoroacetabular Impingement: What the Surgeon Wants to Know

Femoroacetabular Impingement: What the Surgeon Wants to Know

Anatomical variation of the Psoas Valley: a scoping review

Hip Joint Capsular Anatomy, Mechanics, and Surgical Management

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