Passive Hip Range of Motion Predicts Femoral Torsion and Acetabular Version

Chadayammuri, Vivek; Garabekyan, Tigran; Bedi, Asheesh; Pascual‐Garrido, Cecilia; Rhodes, Jason; O’Hara, John N.; Mei-Dan, Omer

doi:10.2106/jbjs.o.00334

Cited by 101 publications

(123 citation statements)

References 46 publications

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“…Recently Chadayammuri et al reported decreased degree of hip exion (mean 104 0 ) with acetabular retroversion with no effect of femoral torsion [7]. At an anatomic study of ischio-femoral impingement model with concamittant decrease of terminal hip extension, Gomes-Hoyos et al reported increase of the L3-4 and L4-5 lumbar facet joint load [6].…”

Section: Discussionmentioning

confidence: 99%

“…Both femoral anteversion , acetabular antversion abnormalities have been described in pathogenesis of hip osteoarthritis [7][8][9][10][11][12]15] and hip osteoarthritis is being linked to lumbar spine disease. However; none of study in the literature directly searched causal relationship of these parameters at lumbar disc disease.…”

Section: Discussionmentioning

confidence: 99%

“…Additionally, torsional deformities and/ or limited range of motion of the hip have been reported to be linked to hip osteoarthritis that increase in femoral anteversion and /or acetabular retroversion or decreased acetabular anteversion predisposes to hip osteoarthritis [7][8][9][10][11][12].…”

Section: Introductionmentioning

confidence: 99%

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Hip torsional deformities at lumbar disc disease

Işın

KAYA

Hapa

et al. 2020

Preprint

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Background Presence of lumbar spine disorder with hip diseases is defined as Hip-Spine syndrome, there might be a relation between hip torsional deformities and lumbar disc disease which has not clarified previously. Purpose of the present study was to find whether hip torsional parameters (femur, acetabular anteversion) and clinical findings (hip range of motion, hip score) differ at patients with lumbar disc disease. Methods Patients with lomber disc herniation (n: 20) and control subjects (n: 20) without any lumbar spine or hip disease were enrolled. Femoral anteversion (FeAv), acetabular anteversion (AA), center of edge angle (CE), degree of hip flexion, extension, Harris Hip scores (HHS) were evaluated bilaterally. Results HHS score, degree of extension plus flexion was lower at diseased side when it is compared to the control subjects (p < 0.001). Unilaterally affected patients had lower AA than control subjects (AA: 13 ± 40 vs16 ± 20 p:0.01). Mechanic and /or hip torsional parameters especially the acetabular retroversion may have an etiopathogenetic role at unilateral lumbar disc disease.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hip torsional deformities at lumbar disc disease

Işın

KAYA

Hapa

et al. 2020

Preprint

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“…The clinical tests were all performed by one of three staff hip surgeons. The internal hip rotation was assessed in the sitting position with a goniometer, and the impingement test was performed in the supine position . Inclusion age was 20–50 years.…”

Section: Methodsmentioning

confidence: 99%

Pincer‐type MRI morphology seen in over a third of asymptomatic healthy volunteers without femoroacetabular impingement

Bensler

Dietrich

Zubler

et al. 2018

Magnetic Resonance Imaging

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Background In daily routine, pincer femoroacetabular impingement (FAI) findings are often seen without a clinical diagnosis of pincer FAI. Purpose To assess the presence of pincer FAI MRI findings in asymptomatic volunteers with negative impingement test versus patients with clinically confirmed FAI. Study Type Case–control study. Population Sixty‐three asymptomatic volunteers and 63 matched patients with FAI were included. Field Strength/ Sequence A coronal T1‐weighted turbo spin‐echo sequence as well as a 3D oblique transverse water‐excitation true fast imaging sequence at 1.5T. Assessment The volunteers underwent standard MRI of the hip, and patients underwent MR arthrography of the symptomatic hip using the same MR sequences. Measurements of cranial acetabular version, acetabular depth, and lateral center‐edge angle were performed independently by three fellowship‐trained musculoskeletal radiologists. Statistical Tests Descriptive statistics, Mann–Whitney U‐test, Unpaired t‐test, receiver operating characteristics (ROC), Intraclass correlation coefficient (ICC). Results Forty‐one percent (26/63, reader 1), 32% and 37% (20 and 23/63, reader 2/3) of asymptomatic volunteers had at least one positive MR finding for pincer‐FAI. Patients with pincer or mixed‐type FAI had cranial retroversion of the acetabulum of –0.2° ± 7.1 (mean ± standard deviation) for reader 1 and –0.3° ± 5.5/–0.2° ± 4.8 for reader 2 / reader 3, while asymptomatic volunteers had an anteversion of 6.2° ± 6.4 (reader 1) and 3.2° ± 4.9/3.1° ± 6.5 (readers 2/3): This difference was statistically significant (P ≤ 0.002), but there was a large overlap between the groups. Acetabular depth measurements were very similar for patients with either pincer or mixed‐type FAI (5.1–5.3 mm ± 3.1) and volunteers (5.2–6.1 mm ± 2.6), without a statistically significant difference (P ≤ 0.50). Lateral center‐edge angle was also similar in patients with either pincer or mixed‐type FAI (32.1–35.1° ± 9.1) and volunteers (30.7–33.2° ± 6.5), without a statistically significant difference (P ≤ 0.28). Data Conclusion There is a large overlap in pincer‐type MRI findings between patients with symptomatic FAI and asymptomatic volunteers. More than a third of volunteers exhibited at least one positive pincer‐type MRI finding. Level of Evidence: 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:1296–1303.

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“…Previous study has indicated a significant association between internal rotation range of motion and femoral anteversion [10]. Crane found that children with increased femoral anteversion angle had internal rotation of the hip exceeding 60° [5].…”

Section: Introductionmentioning

confidence: 99%

Therapeutic Effect of Microcurrent Therapy in Children With In-toeing Gait Caused by Increased Femoral Anteversion: A Pilot Study

et al. 2017

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ObjectiveTo investigate the efficacy of portable microcurrent therapy device (PMTD) of the hip internal rotators in the treatment of in-toeing gait caused by increased femoral anteversion in children over 8 years of age.MethodsEleven children (22 legs; 4 boys and 7 girls; mean age, 10.4±1.6 years) with in-toeing gait caused by increased femoral anteversion were included in the present study. All children received 60 minutes of PMTD (intensity, 25 µA; frequency, 8 Hz) applied to the hip internal rotators daily for 4 weeks. Hip internal rotation (IR) angle, external rotation (ER) angle, and midmalleolar-second toe angle (MSTA) measurement during stance phase at transverse plane and Family Satisfaction Questionnaire, frequency of tripping and fatigue like pains about the PMTD were performed before treatment and at 4 weeks after initial PMTD treatment. Paired t-test and Fisher exact test were used for statistical analysis.ResultsHip IR/ER/MSTA was 70.3°±5.4°/20.1°±5.5°/–11.4°±2.7°, and 55.7°±7.8°/33.6°±8.2°/–2.6°±3.8° before treatment and at 4 weeks after initial PMTD treatment, respectively (p<0.01). Ten of 11 (91%) children's family stated that they were generally satisfied with the PMTD treatment. The frequency of tripping and fatigue like pains was significantly lower at 4 weeks after PMTD treatment (p<0.05). Excellent inter-rater and intra-rater reliability was observed for repeated MSTA measurements between the examiners (k=0.91–0.96 and k=0.93–0.99), respectively.ConclusionPMTD of the hip internal rotators can be effective in improving the gait pattern of children with in-toeing gait caused by increased femoral anteversion.

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Passive Hip Range of Motion Predicts Femoral Torsion and Acetabular Version

Abstract: This study confirmed that passive hip range of motion significantly predicts combined femoral torsion and central acetabular version. Accurate clinical assessment of the COTAV index may inform surgical decision-making in hip preservation surgery.

Cited by 101 publications

References 46 publications

Hip torsional deformities at lumbar disc disease

Hip torsional deformities at lumbar disc disease

Pincer‐type MRI morphology seen in over a third of asymptomatic healthy volunteers without femoroacetabular impingement

Therapeutic Effect of Microcurrent Therapy in Children With In-toeing Gait Caused by Increased Femoral Anteversion: A Pilot Study

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