Size and shape of the lunate surface in different types of pincer impingement: theoretical implications for surgical therapy

Steppacher, Simon D.; Lerch, Till; Gharanizadeh, Kaveh; Liechti, Emanuel F; Werlen, Stefan; Puls, Marc; Tannast, Moritz; Siebenrock, Klaus A.

doi:10.1016/j.joca.2014.05.010

Cited by 85 publications

(105 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…This finding is in agreement with previously published data showing that certain types of deep acetabula have decreased lunate cartilage surface area compared with normal hips [27]. Thus, our deep subtype 2 acetabula have similar characteristics to the retroverted acetabula described by Steppacher and colleagues in that our deep subtype 2 was also observed to have smaller lunate cartilage size and larger cotyloid fossa size.…”

Section: Discussionsupporting

confidence: 93%

“…Thus, our deep subtype 2 acetabula have similar characteristics to the retroverted acetabula described by Steppacher and colleagues in that our deep subtype 2 was also observed to have smaller lunate cartilage size and larger cotyloid fossa size. In comparison, our deep subtype 1 acetabula are similar to the protrusio acetabula that they described, which is characterized by increased lunate cartilage widths and normal to increased cotyloid fossa size [27].…”

Section: Discussionsupporting

confidence: 85%

“…Another CTbased study reported a 26% decrease in contact area in dysplastic hips compared with normal hips [12]. Most recently, Steppacher et al [27] found a 16% decrease in lunate cartilage surface area in dysplastic hips compared with normal hips. We found a comparable 21% reduction of superior lunate cartilage width in dysplastic acetabula compared with control acetabula.…”

Section: Discussionmentioning

confidence: 97%

“…One concern regarding rim trimming is that it may decrease articular surface size to a critical threshold where increased joint contact forces lead to joint degeneration. Therefore, consideration of acetabular lunate cartilage size may be important in choosing which surgical tactic to pursue, but limited data exist regarding detailed pincer acetabular morphology [27].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies using CT of human hips have measured the contours of the bony acetabulum [13], the relative coverage of the femoral head by the acetabulum in developmental dysplasia of the hip [1,2,5,7], and the contact pressure between the acetabulum and the femoral head [12]. However, these studies have focused on normal and dysplastic hips and did not directly visualize the articular cartilage using MR. Steppacher and colleagues [27] used MR radial sequences to examine protrusio, deep, and retroverted acetabula, finding that retroverted acetabula had smaller cartilage surfaces than deep and protrusio acetabula. However, the measurements in these previous CT and MR studies were subject to imaging reformatting that can influence the accuracy of measurements because the measurements were obtained on either standard axial and coronal reformats, which section the acetabulum obliquely, or radial images that reference the femoral neck axis to determine the center of the acetabulum.…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Is Increased Acetabular Cartilage or Fossa Size Associated With Pincer Femoroacetabular Impingement?

Pun

Hingsammer

Millis

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

Background Surgical treatment for pincer femoroacetabular impingement (FAI) of the hip remains controversial, between trimming the prominent acetabular rim and reverse periacetabular osteotomy (PAO) that reorients the acetabulum. However, rim trimming may decrease articular surface size to a critical threshold where increased joint contact forces lead to joint degeneration. Therefore, knowledge of how much acetabular articular cartilage is available for resection is important when evaluating between the two surgical options. In addition, it remains unclear whether the acetabulum rim in pincer FAI is a prominent rim because of increased cartilage size or increased fossa size. Questions/purposes We used reformatted MR and CT data to establish linear length dimensions of the lunate cartilage and cotyloid fossa in normal, dysplastic, and deep acetabula. Methods We reviewed the last 200 hips undergoing PAO, reverse PAO, and surgical dislocation for acetabular rim trimming at one institution. We compared MR images of symptomatic hips with acetabular dysplasia (20 hips), pincer FAI (29 hips), and CT scans of asymptomatic hips from patients who underwent CT scans for reasons other than hip pain (20 hips). These hips were chosen sequentially from the underlying pool of 200 potential subjects to identify the first 10 male and the first 10 female hips in each group that met inclusion criteria. As a result of low numbers, we included all hips that had undergone reverse PAO and met inclusion criteria. Cartilage width was measured medially from the cotyloid fossa to the lateral labrochondral junction. Cotyloid fossa linear height was measured from superior to inferior and cotyloid fossa width was measured from anterior to posterior. Superior lunate cartilage width (SLCW) and cotyloid fossa height (CFH) were measured on MR and CT oblique coronal reformats; anterior lunate cartilage width (ALCW), posterior lunate cartilage width (PLCW), and cotyloid fossa width (CFW) were measured on MR and CT oblique axial reformats. Cohorts were compared using multivariate analysis of variance with Bonferroni's adjustment for multiple comparisons.Results Compared with control acetabula, dysplastic acetabula had smaller SLCW (2.08 ± 0.29 mm versus 2.63 Clinical Orthopaedics and Related Research ®A Publication of The Association of Bone and Joint Surgeons® ± 0.42 mm, mean difference = À0.55 mm; 95% confidence interval [CI] = À0.83 to À0.27; p \ 0.01), ALCW (1.20 ± 0.34 mm versus 1.64 ± 0.21 mm, mean difference = À0.44 mm; 95% CI = À0.70 to À0.18; p = 0.00), CFH (2.84 ± 0.37 mm versus 3.42 ± 0.57 mm, mean difference = À0.59 mm; 95% CI = À0.96 to À0.21; p \ 0.01), and CFW (1.98 ± 0.50 mm versus 2.77 ± 0.33 mm, mean difference = À0.80 mm; 95% CI = À1.16 to À0.42; p \ 0.0001). Based on the results, we identified two subtypes of deep acetabula. Compared with controls, deep subtype 1 had normal CFH and CFW but increased ALCW (2.09 ± 0.42 mm versus 1.64 ± 0.21 mm; p \ 0.001) and PLCW (2.32 ± 0.36 mm versus 2.00 ± 0.32 mm; p = 0.04). Compared ...

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Is Increased Acetabular Cartilage or Fossa Size Associated With Pincer Femoroacetabular Impingement?

Pun

Hingsammer

Millis

et al. 2017

Clinical Orthopaedics &Amp; Related Research

View full text Add to dashboard Cite

show abstract

The Anthropoid Crista Trochanterica and the Hip Joint Capsule

Hammond

2015

The Anatomical Record

View full text Add to dashboard Cite

The tubercle on the posterior aspect of the femoral neck (the crista trochanterica) has been repeatedly remarked upon because of its presence in early fossil apes, yet the function of this tubercle has eluded researchers. The prevailing explanation for the tubercle is that it relates to a strong ischiofemoral ligament, although none of the hypotheses for this bony projection have been systematically evaluated. This study surveyed 41 extant anthropoid species (n 5 267 individuals) for the presence of a crista trochanterica. The soft tissue structures of the hip joint were then dissected and described for a sample of anthropoid cadavers (n 5 14) in order to evaluate different hypotheses related to function of this tubercle. This study confirmed that the crista trochanterica is found in most cercopithecoids and platyrrhines, and is not present in great apes. The tubercle is rarely present in hylobatids, contrary to prior reports. The ischiofemoral ligament is not usually well-developed in anthropoids and does not fully explain the crista trochanterica morphology, although all cadavers displayed a well-developed zona orbicularis running along the posterior aspect of the joint capsule. The hip joint capsule itself inserted along the crista trochanterica in some individuals, typically those with an elongate crista trochanterica, but was highly variable in regards to the position of the tubercle. The hypotheses for the crista trochanterica are considered within the context of these findings, although the exact function of the tubercle remains unresolved. Anat Rec, 299:60-69, 2016. V C 2015 Wiley Periodicals, Inc.

show abstract

Measurement of acetabular version based on biplanar radiographs with 3D reconstructions in comparison to CT as reference standard in cadavers

et al. 2017

View full text Add to dashboard Cite

To quantify acetabular version using 3 D reconstructions based on biplanar radiographs (BPR) with CT as reference standard. No institutional review board approval was needed. Nine dry-bone pelvises underwent BPR in five different positions (rotation/tilt). The 3 D models of each pelvis were reconstructed by two radiologists on the basis of anatomical landmarks using semi-automated software. Automated software was used to assess the 3 D models and to calculate acetabular versions perpendicular to the anterior pelvic plane on all levels in the craniocaudal direction in 1 mm steps. Transverse CT images perpendicular to the anterior pelvic plain were reconstructed through the acetabulum in 1 mm steps. Both readers measured acetabular version on each image. Inter-reader agreement was calculated. Measurements based on BPR and CT were compared. Inter-reader agreement was almost perfect for BPR-based acetabular version measurements (ICC (intraclass correlation coefficient) = 0.920, P < 0.0005) and CT (ICC = 0.990, P < 0.0005). Correlation of acetabular versions between the five BPR-positions was substantial/almost perfect (ICC = 0.722-0.887 and 0.749-0.872 for readers 1 and 2, respectively; most P < 0.0005). The acetabular version measurements between the ap-positioning from BPR and CT showed moderate agreement (mean CCC (concordance correlation coefficient) = 0.733 for reader 1, CCC = 0.755 for reader 2). Acetabular version on multiple levels can be measured using BPR and dedicated post-processing software and is relatively independent of pelvic rotation and tilt. Clin. Anat. 30:591-598, 2017. © 2017 Wiley Periodicals, Inc.

show abstract

Size and shape of the lunate surface in different types of pincer impingement: theoretical implications for surgical therapy

Cited by 85 publications

References 27 publications

Is Increased Acetabular Cartilage or Fossa Size Associated With Pincer Femoroacetabular Impingement?

Is Increased Acetabular Cartilage or Fossa Size Associated With Pincer Femoroacetabular Impingement?

The Anthropoid Crista Trochanterica and the Hip Joint Capsule

Measurement of acetabular version based on biplanar radiographs with 3D reconstructions in comparison to CT as reference standard in cadavers

Contact Info

Product

Resources

About