Arthroscopic Appearance and Treatment of Impingement Cysts at Femoral Head-Neck Junction

Leunig, Michael; Mast, Nicholas H.; Impellizerri, Franco M.; Ganz, Reinhold; Panaro, Carlo

doi:10.1016/j.arthro.2011.07.010

Cited by 13 publications

(12 citation statements)

References 14 publications

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“…Impingement cysts are frequently seen on the femoral head neck junction in patients undergoing hip arthroscopy for FAI and are found predictably within the epicentre of the femoral-induced impingement 5 . Cysts can also be found in the labrum as degenerative process or secondary to iliopsoas impingement.…”

Section: Discussionmentioning

confidence: 99%

Medial synovial fold cyst in the hip leading to pectineofoveal impingement

Nakano¹,

Khanduja²

2016

J Hip Preserv Surg

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Pectineofoveal impingement is a relatively rare condition, which can cause hip or groin pain along with mechanical symptoms of clicking in the young adult. We present the case of a 13-year-old girl who was referred to us with left hip pain, which had been affecting her for over six months along with mechanical symptoms of clicking. Following appropriate clinical examination and investigations the patient underwent arthroscopic surgery of her hip. At arthroscopy, a cyst was identified on the medial synovial fold, which was abutting against the zona orbicularis leading to pectineofoveal impingement. The cyst was decompressed and the synovial fold excised arthroscopically. Following arthroscopic intervention, the patient did extremely well and remains asymptomatic at the last follow-up (7 months following the procedure). The case highlights the importance of the medial synovial fold pathology as an important cause for pain and mechanical symptoms in the young adult hip.

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Section: Discussionmentioning

confidence: 99%

Medial synovial fold cyst in the hip leading to pectineofoveal impingement

Nakano¹,

Khanduja²

2016

J Hip Preserv Surg

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“…Additionally, characteristic femoral chondral fibrocystic changes, today called impingement cysts [11], previously named herniation pits, are localized at the head-neck junction distal to the physis and frequently visible radiographically [11,12,15,18]. Histologically these lesions consist of proliferative fibroblasts forming either dense fibrous tissue or gelatinous tissue.…”

Section: Introductionmentioning

confidence: 99%

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Zaltz¹,

Leunig

2012

Clinical Orthopaedics &Amp; Related Research

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Background Cam-type, pincer, and mixed femoroacetabular impingement (FAI) are accepted causes of labral and acetabular rim injury; however, the abnormal contact stresses associated with motion may damage other areas of the hip. Although cartilage damage to the femoral head has been reported previously in athletes, FAI-associated focal parafoveal chondral defects differ from previously reported lesions and represent a rare manifestation of the complex pathomechanics associated with FAI.

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“…First described in 1981, the herniation pit was d e f i n e d a s a s u b c o r t i c a l c y s t i c l e s i o n a t t h e anterosuperior quadrant of the femoral head [2] caused by invagination of synovia into the bone through erosions or perforations. At arthroscopy, the herniation pit was described as having a pit-like or crater-like appearance [18]. After arthroscopic unroofing of the cystic lesion, there appeared a sclerotic bone base filled with gelatinous to fibrous-like material [18].…”

Section: Discussionmentioning

confidence: 99%

Osseous defect of the anteroinferior femoral head: is it associated with femoroacetabular impingement (FAI)?

et al. 2021

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Objective To evaluate the prevalence, morphology, and clinical significance of a repeatedly observed yet not examined circumscript osseous defect at the anteroinferior aspect of the femoral head, termed femoral head defect. Materials and methods Retrospective study with approval of the institutional review board. There was informed consent by all individuals. Magnetic resonance imaging (MRI) hip examinations of 970 individuals (age 15 to 55) were analyzed for femoral head defect. Patients with femoral head defect were matched for age and gender with patients without defect. Two readers independently assessed MRI images regarding presence, location, and morphology of the defect. MR images and radiographs were analyzed for findings of femoroacetabular impingement (FAI). Femoral torsion was measured. Independent t test and chi-square test were used for statistics. Results Sixty-eight (7%) of 970 MRI examinations exhibited a femoral head defect in an anteroinferior location of the femoral head (29/400 men, 7.3%; 39/570 women, 6.8%; p = 0.8). The most frequent morphology of femoral head defect was type I, dent-like (34; 50%), followed by type II, crater-like (27; 40%), and III, cystic (7; 10%). Femoral head defect was slightly more common on the right hip (39 individuals; 57%) compared to left (29 individuals; 43%), non-significantly (p = 0.115). There was no association between FAI or its subtypes and the presence of femoral head defect (p = 0.890). Femoral antetorsion was reduced in patients with femoral head defect (12.9° ± 8.6) compared to patients without defect (15.2° ± 8.5), without statistical significance (p = 0.121). Conclusion The femoral head defect is a common finding in MRI examinations of the hip and is situated in the anteroinferior location. There was no association with FAI yet a non-significant trend towards lower femoral antetorsion in patients with femoral head defects.

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Arthroscopic Appearance and Treatment of Impingement Cysts at Femoral Head-Neck Junction

Cited by 13 publications

References 14 publications

Medial synovial fold cyst in the hip leading to pectineofoveal impingement

Medial synovial fold cyst in the hip leading to pectineofoveal impingement

Parafoveal Chondral Defects Associated with Femoroacetabular Impingement

Osseous defect of the anteroinferior femoral head: is it associated with femoroacetabular impingement (FAI)?

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