Cam and Pincer Femoroacetabular Impingement: CT Findings of Features Resembling Femoroacetabular Impingement in a Young Population Without Symptoms

Chakraverty, Julian; Sullivan, Carl M.; Gan, Chee L; Narayanaswamy, Srikanth; Kamath, Sridhar

doi:10.2214/ajr.12.8546

Cited by 71 publications

(66 citation statements)

References 31 publications

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“…1A). Anterior femoral head-neck offset was also observed on the oblique-axial plane [11,26], measuring the offset distance between the two tangents of the anterior femoral head and neck (Fig. 1A).…”

Section: Methodsmentioning

confidence: 99%

“…1E-F) [10,15]. Acetabular version was measured on the transverse plane coincident with the left and right femoral head centers [11,12,41]. This angle was formed by the line connecting the anterior and posterior acetabular notches and the perpendicular axis to the posterior acetabular notch (Fig.…”

Section: Methodsmentioning

confidence: 99%

“…Many individuals with cam deformities may not experience mechanical impingement or pain symptoms, thus qualifying them as asymptomatic individuals [11,18,26,43]. Therefore, we postulated that FAI symptoms may be related to other anatomical parameters that can exacerbate mechanical impingement in patients at risk of developing symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Patient-Specific Anatomical and Functional Parameters Provide New Insights into the Pathomechanism of Cam FAI

Lamontagne

Adamczyk

et al. 2015

Clinical Orthopaedics &Amp; Related Research

104

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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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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Patient-Specific Anatomical and Functional Parameters Provide New Insights into the Pathomechanism of Cam FAI

Lamontagne

Adamczyk

et al. 2015

Clinical Orthopaedics &Amp; Related Research

104

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“…In only a few studies have both the cam and pincer type radiological parameters been analyzed in asymptomatic patients. For instance, Chakraverty et al (2) found at least one abnormal parameter in 66% of 100 joints, and two or more abnormal parameters were present in 29% of the joints without symptoms. In another study, Kang et al (13) found that 39% of 100 joints had at least one parameter, and that 11% had more than one parameter associated with FAIs in asymptomatic patients.…”

Section: Discussionmentioning

confidence: 99%

“…Femoroacetabular impingement (FAI) is one cause of hip pain, and is an under-recognized cause of early osteoarthritis, especially in young and active people (1,2). The prevalence of FAI in adults is approximately 10-15% (3) and, depending on the clinical and radiographic findings, two types of impingement (which are often present in combination) can be distinguished: the cam type and the pincer type.…”

Section: Introductionmentioning

confidence: 99%

Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in an Asymptomatic Young Population

et al. 2016

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Background: Femoroacetabular impingement (FAI) is one cause of hip pain, and is an under-recognized cause of early osteoarthritis, especially in young and active people. The prevalence of FAI in adults is approximately 10 -15% and depending on the clinical and radiographic findings, two types of impingement (which are often present in combination) can be distinguished: the cam type and the pincer type. Most patients (86%) have a combination of both forms of impingement.

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High prevalence of cam deformity in dysplastic hips: A three‐dimensional CT study

Kohno

Hatano

Akiyama

et al. 2016

Journal Orthopaedic Research

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Cam deformity could lead to suboptimal articulation by causing secondary femoroacetabular impingement after periacetabular osteotomy; however, the inherent femoral head-neck morphology in dysplastic hips and the effect of an additional osteoarthritic deformity have not been well described. We compared femoral head-neck morphology using three-dimensional imaging of normal and dysplastic hips in pre/early (T€ onnis grade 0 and 1) and advanced stage osteoarthritis (T€ onnis grade 2). Using computed tomography, we measured the circumferential a-angle and head-neck offset ratio in 68 dysplastic hips and 24 normal hips. Locations of the head-neck junction were represented by the clock position. In the pre/early group, the a-angle was significantly larger at the anterosuperior and inferior aspects (1, 2, and 5-7 o'clock) and head-neck offset ratio was smaller at the anterosuperior aspect (2 o'clock) than in the control group. The a-angle was significantly larger at the anterior aspects (1-4 o'clock) in the advanced group than in the pre/early group. The maximum a-angle was most commonly found at 2 o'clock (60%, 41/68 hips) in dysplastic hips. The prevalence of cam deformity (maximum a-angle >55˚) was 4.2% (1/24 hips) in the control group, 22% (11/50 hips) in the pre/early group, and 50% (9/18 hips) in the advanced group. Cam deformity, inherent in the pre/early group, was found with relatively high frequency. The higher prevalence in the advanced group reflected degeneration-modified changes. When performing periacetabular osteotomy, preoperative radiographic assessments should include the femoral head-neck junction to prevent secondary femoroacetabular impingement, especially in patients with advanced stage osteoarthritis. ß

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Cam and Pincer Femoroacetabular Impingement: CT Findings of Features Resembling Femoroacetabular Impingement in a Young Population Without Symptoms

Cited by 71 publications

References 31 publications

Patient-Specific Anatomical and Functional Parameters Provide New Insights into the Pathomechanism of Cam FAI

Patient-Specific Anatomical and Functional Parameters Provide New Insights into the Pathomechanism of Cam FAI

Radiological Assessment of Femoroacetabular Impingement Morphology Using Computed Tomography in an Asymptomatic Young Population

High prevalence of cam deformity in dysplastic hips: A three‐dimensional CT study

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