Impingement and childhood hip disease

Wenger, Dennis R.; Kishan, Shyam; Pring, Maya E.

doi:10.1097/01202412-200607000-00001

Cited by 64 publications

(41 citation statements)

References 27 publications

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“…The current study included only patients with underlying FAI and the findings may not be applicable to those without such deformity. However, the vast majority of patients presenting with symptomatic labral tears have evidence of underlying FAI pathomorphology [23]. Finally, all patients within the study underwent surgical treatment of FAI and thus did not include patients who were treated without surgery.…”

Section: Discussionmentioning

confidence: 99%

Functional Acetabular Orientation Varies Between Supine and Standing Radiographs: Implications for Treatment of Femoroacetabular Impingement

Ross

Tannenbaum

Nepple

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Often, anteroposterior (AP) pelvic radiographs are performed with the patient positioned supine. However, this may not represent the functional position of the pelvis and the acetabulum, and so when assessing patients for conditions like femoroacetabular impingement (FAI), it is possible that standing radiographs better incorporate the dynamic influences of periarticular musculature and sagittal balance. However, this thesis remains largely untested. Questions/purposes The purpose of this study was to determine the effect of supine and standing pelvic orientation on (1) measurements of acetabular version and common radiographic signs of FAI as assessed on two-and three-dimensional (3-D) imaging; and (2) on terminal hip range of motion (ROM). Methods Preoperative pelvic CT scans of 50 patients (50 hips) who underwent arthroscopic surgery for the treatment of FAI between July 2013 and October 2014 were analyzed. The mean age of the study population was 29 ± 10 years (range, 15-50 years) and 70% were male. All patients had a standing AP pelvis radiograph, a reconstructed supine radiograph from the CT data, and a 3-D model created to allow manipulation of pelvic tilt and simulate ROM to osseous contact. Acetabular version was measured and the presence of the crossover sign, prominent ischial spine sign, and posterior wall sign were recorded on simulated plain radiographs. Measurements of ROM to bony impingement were made during (1) simulated hip flexion; (2) simulated internal rotation in 90°of flexion (IRF); and (3) simulated internal rotation in 90°of flexion and 15°adduction (FADIR), and the location of bony One or more of the authors has received funding outside of submitted work from Smith & Nephew (Andover, MA, USA) (JJN); Smith & Nephew and A3 Surgical (La Tronche, France) (CML); and Smith & Nephew, A3 Surgical, and Pivot (Sunnyvale, CA, USA) (BTK, AB). During the study period, an amount less than USD 10,000 was received. One or more of the authors has stock/stock options in A3 Surgical (CML, AB) and A3 Surgical and Pivot (BTK Clin Orthop Relat Res (2015) 473:1267-1273 DOI 10.1007/s11999-014-4104-x Clinical Orthopaedics and Related Research ® A Publication of The Association of Bone and Joint Surgeons®contact between the proximal femur and acetabular rim was defined. These measurements were calculated for supine and standing pelvic orientations. A paired Student's t-test was used for comparison of continuous variables, whereas chi square testing was used for categorical variables. A p value of \ 0.05 was considered significant. Results When changing from supine to the standing radiographs, both mean cranial and central version increased by 2°± 4°(95% confidence interval [CI], 1°-3°) and 2°± 3°(95% CI, 1°-3°), respectively (both p \ 0.001). However, with the numbers available, there were no changes in the proportion of positive crossover, posterior wall, and prominent ischial spine signs. Standing pelvic position tilt resulted in an increased hip flexion of 3°( 95% CI, 2°-4°) as well as an i...

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Section: Discussionmentioning

confidence: 99%

Functional Acetabular Orientation Varies Between Supine and Standing Radiographs: Implications for Treatment of Femoroacetabular Impingement

Ross

Tannenbaum

Nepple

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Femoroacetabular impingement (FAI), or abutment of the anterior femoral head-neck junction against the anterior acetabular rim or labrum [5,15,19,20,29,39], has been the focus of increasing research in the past decade and is reportedly an etiologic factor in osteoarthritis (OA) of the hip [5,10,15,24,25,31,32,[40][41][42]. Because of this apparent relationship, Ganz et al, among others, have advocated early surgical intervention in symptomatic hips [15,23,31,36,40].…”

Section: Introductionmentioning

confidence: 99%

Open Treatment of Femoroacetabular Impingement is Associated with Clinical Improvement and Low Complication Rate at Short-term Followup

Peters

Schabel

Anderson

et al. 2010

Clinical Orthopaedics &Amp; Related Research

107

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“…In addition, the amount of anterior offset can be measured as the distance from a line that is tangential to the convexity of the femoral head to another line that is parallel to the femoral neck. Less than 9-11 mm of offset may indicate cam-type deformity that is significant but distinct from femoral head asphericity [17,18]. The femoral neck-shaft angle determines the amount of relative coxa valga or coxa vara, with values greater than 135°and less than 120°suggestive of the former and latter, respectively.…”

Section: Radiographymentioning

confidence: 99%

A review of imaging modalities for the hip

Weber

Jacobson

Bedi

2013

Curr Rev Musculoskelet Med

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Hip arthroscopy is one of the fastest growing surgical procedures performed by orthopaedic surgeons, with the number of hip arthroscopies expected to double in 2013. The increase in surgical prevalence is at least in part due to an increased awareness of prearthritic hip pathology. The diagnoses of prearthritic hip conditions are made through a comprehensive history, physical examination, and selection of appropriate diagnostic imaging modalities. The purpose of this review article is to provide the practicing orthopaedic surgeon with an overview of the imaging modalities available for the diagnosis of prearthritic hip pathology, with a focus on literature supporting advancements in imaging techniques and new applications of existing modalities.

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Impingement and childhood hip disease

Cited by 64 publications

References 27 publications

Functional Acetabular Orientation Varies Between Supine and Standing Radiographs: Implications for Treatment of Femoroacetabular Impingement

Functional Acetabular Orientation Varies Between Supine and Standing Radiographs: Implications for Treatment of Femoroacetabular Impingement

Open Treatment of Femoroacetabular Impingement is Associated with Clinical Improvement and Low Complication Rate at Short-term Followup

A review of imaging modalities for the hip

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