Anterior Inferior Iliac Spine Deformity as an Extra-Articular Source for Hip Impingement: A Series of 10 Patients Treated With Arthroscopic Decompression

Hetsroni, Iftach; Larson, Christopher M.; Torre, Katrina Dela; Zbeda, Robert M.; Magennis, Erin; Kelly, Bryan T.

doi:10.1016/j.arthro.2012.05.882

Cited by 179 publications

(190 citation statements)

References 22 publications

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“…Over time, a displaced avulsion fracture may develop into a prominent bony deformity of the AIIS, which can be more accurately visualised at CT or MRI, and is often point shaped [23]. In some cases, calcified deposits are found within the proximal portion of the straight head of the rectus femoris tendon and impingement cysts are found on the distal femoral neck [21].…”

Section: Managementmentioning

confidence: 99%

“…Patients who fail conservative treatment, an AIIS decompression is often performed through the standard anterolateral and mid-anterior hip arthroscopy portals. A concomitant arthroscopic procedure is sometimes conducted to address any intra-articular pathology as well [23]. Arthroscopic resection of an impinging AIIS has also been reported by some experienced hip arthroscopists [21,23,25,27], and studies have shown good short-term outcomes up to two years follow-up for a return to sporting activity, increased ROM, Harris hip score and visual analogue scale [21,23,27].…”

Section: Managementmentioning

confidence: 99%

“…The AIIS may also become more prominent following pelvic osteotomy or injury to the AIIS. In adolescents, repetitive traction injuries can cause apophysitis, hypertrophy, inferior displacement of the apophysis or fracture which can lead to malunion resulting in an enlarged AIIS or a bony protrusion, thereby causing subspine impingement [23].…”

Section: Aetiology and Clinical Featuresmentioning

confidence: 99%

“…MR arthrography is also beneficial to rule out damage to the labrum and articular cartilage secondary to ongoing FAI. It is important to note that there may only be partial or no pain relief and a persistent limitation of hip flexion after intraarticular administration of a local anaesthetic [23].…”

Section: Managementmentioning

confidence: 99%

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Current concepts in the diagnosis and management of extra-articular hip impingement syndromes

Nakano

Yip

Khanduja

2017

International Orthopaedics (SICOT)

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Purpose Extra-articular hip impingement syndromes encompass a group of conditions that have previously been an unrecognised source of pain in the hip and on occasion been associated with intra-articular hip impingement as well. As arthroscopic techniques for the hip continue to evolve, the importance of these conditions has been recognised recently and now form an important part of the differential of an individual presenting with hip pain. The aim of this article, therefore, is to provide the reader with an evidence-based and comprehensive update of these syndromes. Methods By reviewing past literature, the anatomy, pathophysiology, clinical features and the management of the five common extra-articular hip impingement syndromes were described. Results The common extra-articular impingement syndromes are: 1) Ischiofemoral impingement: quadratus femoris muscle becomes compressed between the lesser trochanter and the ischial tuberosity. 2) Subspine impingement: mechanical conflict occurs between an enlarged or malorientated anterior inferior iliac spine and the distal anterior femoral neck. 3) Iliopsoas impingement: mechanical conflict occurs between the iliopsoas muscle and the labrum, resulting in distinct anterior labral pathology. 4) Deep gluteal syndrome: pain occurs in the buttock due to the entrapment of the sciatic nerve in the deep gluteal space. 5) Pectineofoveal impingement: pain occurs when the medial synovial fold impinges against overlying soft tissue, primarily the zona orbicularis. Knowledge for these syndromes still remains limited for reasons mostly relating to their low prevalence and their co-existence with typical femoro-acetabular impingement. Conclusions The knowledge of extra-articular hip impingement syndromes is essential and should form a part of the differential diagnoses alongside intra-articular pathology including femoro-acetabular impingement particularly in the younger patient with a non-arthritic hip.

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Section: Managementmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

Section: Aetiology and Clinical Featuresmentioning

confidence: 99%

Section: Managementmentioning

confidence: 99%

See 2 more Smart Citations

Current concepts in the diagnosis and management of extra-articular hip impingement syndromes

Nakano

Yip

Khanduja

2017

International Orthopaedics (SICOT)

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“…This impingement is clinically significant as it results in decreased range of motion and hip pain. 3 Table 1 describes hints for clinical diagnosis of low AIIS.…”

mentioning

confidence: 99%

Surgical Technique: Arthroscopic Osteoplasty of Anterior Inferior Iliac Spine for Femoroacetabular Impingement

Sharfman

Grundshtein

Paret

et al. 2016

Arthroscopy Techniques

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The anterior inferior iliac spine (AIIS) has variable morphology that correlates with hip range of motion. Subspinal impingement is an extracapsular cause for femoroacetabular impingement (FAI) and is clinically significant because it results in decreased range of motion and groin pain with flexion-based activity. In symptomatic patients with AIIS extension to or below the acetabular rim, AIIS decompression is considered part of an FAI corrective procedure. A consistent exposed bony area on the anterior and inferomedial aspect of the AIIS serves as a "safe zone" of resection allowing for decompression with preservation of the origin of the rectus femoris tendon. This surgical note describes a technique for AIIS decompression. The goal for low AIIS osteoplasty is to resect the AIIS to 2 burr widths (using a 5.5-mm burr) above the acetabular rim, achieving an 11-mm clearance, creating a type I AIIS. The resultant flat anterior acetabular surface between the most anteroinferior prominent point of the AIIS and the acetabular rim allows for free movement of the hip joint without impingement. Careful execution of AIIS decompression can alleviate clinical symptoms of FAI and restore function to the hip joint.

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Sonographic Overview of Usual and Unusual Disorders of the Rectus Femoris Tendon Origins

Moraux

Balbi

Cockenpot

et al. 2017

J of Ultrasound Medicine

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Rectus femoris muscle proximal injuries are not rare conditions. The proximal rectus femoris tendinous anatomy is complex and may be affected by traumatic, microtraumatic, or nontraumatic disorders. A good knowledge of the proximal rectus femoris anatomy allows a better understanding of injury and disorder patterns. A new sonographic lateral approach was recently described to assess the indirect head of the proximal rectus femoris, hence allowing for a complete sonographic assessment of the proximal rectus femoris tendons. This article will review sonographic features of direct, indirect, and conjoined rectus femoris tendon disorders.

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Anterior Inferior Iliac Spine Deformity as an Extra-Articular Source for Hip Impingement: A Series of 10 Patients Treated With Arthroscopic Decompression

Cited by 179 publications

References 22 publications

Current concepts in the diagnosis and management of extra-articular hip impingement syndromes

Current concepts in the diagnosis and management of extra-articular hip impingement syndromes

Surgical Technique: Arthroscopic Osteoplasty of Anterior Inferior Iliac Spine for Femoroacetabular Impingement

Sonographic Overview of Usual and Unusual Disorders of the Rectus Femoris Tendon Origins

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