Tensile Strain in the Anterior Part of the Acetabular Labrum During Provocative Maneuvering of the Normal Hip

Dy, Christopher J.; Thompson, Matthew; Crawford, Matthew J.; Alexander, Jerry W.; McCarthy, Joseph C.; Noble, Philip C.

doi:10.2106/jbjs.g.00467

Cited by 80 publications

(69 citation statements)

References 17 publications

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“…In a preliminary investigation, the authors tested MRI, which proved inaccurate due to technical problems such as mirror images in deep flexion, poor-quality images due to temperature variations within specimens, small diameter of the MRI tube, which does not accommodate the knee in flexion. Finally, the study did not analyse the strain in the popliteus because inserting strain gauges [19] would compromise the image quality by scattering and even the use of chromium steel spheres precludes good soft-tissue analysis [17]. …”

Section: Discussionmentioning

confidence: 99%

Popliteus impingement after TKA may occur with well-sized prostheses

Bonnin

Kok

Verstraete

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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PurposeTo determine the mechanisms and extents of popliteus impingements before and after TKA and to investigate the influence of implant sizing. The hypotheses were that (1) popliteus impingements after TKA may occur at both the tibia and the femur, and (2) even with an apparently well-sized prosthesis, popliteal tracking during knee flexion is modified compared to the preoperative situation.MethodsThe location of the popliteus in three cadaver knees was measured using computed tomography, before and after implantation of plastic TKA replicas, by injecting the tendon with radiopaque liquid. The pre- and post-operative positions of the popliteus were compared from full extension to deep flexion using normosized, oversized, and undersized implants (one size increments).ResultsAt the tibia, TKA caused the popliteus to translate posteriorly, mostly in full extension: 4.1 ± 2 mm for normosized implants, and 15.8 ± 3 mm with oversized implants, but no translations were observed when using undersized implants. At the femur, TKA caused the popliteus to translate laterally at deeper flexion angles, peaking between 80° and 120°: 2 ± 0.4 mm for normosized implants and 2.6 ± 0.5 mm with oversized implants. Three-dimensional analysis revealed prosthetic overhang at the posterosuperior corner of normosized and oversized femoral components (respectively, up to 2.9 mm and 6.6 mm).ConclusionsA well-sized tibial component modifies popliteal tracking, while an undersized tibial component maintains more physiologic patterns. Oversizing shifts the popliteus considerably throughout the full arc of motion. This study suggests that both femoro- and tibio-popliteus impingements could play a role in residual pain and stiffness after TKA.Electronic supplementary materialThe online version of this article (doi:10.1007/s00167-016-4330-8) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Popliteus impingement after TKA may occur with well-sized prostheses

Bonnin

Kok

Verstraete

et al. 2016

Knee Surg Sports Traumatol Arthrosc

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“…Activities that place the hip joint in end-range flexion, internal rotation, and in some cases abduction are of particular concern. 45, 172 …”

Section: Clinical Guidelines: Interventionsmentioning

confidence: 99%

Nonarthritic Hip Joint Pain

Enseki

Harris‐Hayes

White³

et al. 2014

J Orthop Sports Phys Ther

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“…Other frequently described specific movements in athletics include sudden twisting or pivoting movements,18 as well as recurrent twisting or pivoting movements in moderate-hip flexion or extension without FAI 26. Recent findings suggest that while FAI is one of the primary predisposing factors to ALT,24 25 other conditions such as iliopsoas tendon impingement must also be considered 27 28…”

Section: Anatomy/biomechanics/epidemiology/mechanism Of Injurymentioning

confidence: 99%

Examination of acetabular labral tear: a continued diagnostic challenge

et al. 2013

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Acetabular labrum tears (ALT) are present in 22-55% of individuals with hip or groin pain. Tears can occur as a result of trauma or degeneration and are markedly associated with femoral acetabular morphological variations. An ALT can lead to biomechanical deficiencies and a loss of stability to the coxafemoral joint due to the labrum serving as a stabilising structure of this joint. The diagnosis of ALT is complex and multidimensional. Although tremendous improvements in diagnostic utility for ALT have occurred in the past 25 years, there are few patient history, clinical examination and special test findings that are unique to the condition. Imaging methods such as MRI, CT and ultrasonography have demonstrated reasonable accuracy, but not at a level that allows use as a stand-alone measure. Outcomes measures that focus on functional limitation or that are used to measure recovery should envelop the complexities of the condition and be captured using both self-report and physical performance measures. Only when patient history, objective testing, clinical examination special testing and imaging are combined can a clinician fully elucidate the multidimensional diagnosis of ALT.

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Tensile Strain in the Anterior Part of the Acetabular Labrum During Provocative Maneuvering of the Normal Hip

Cited by 80 publications

References 17 publications

Popliteus impingement after TKA may occur with well-sized prostheses

Popliteus impingement after TKA may occur with well-sized prostheses

Nonarthritic Hip Joint Pain

Examination of acetabular labral tear: a continued diagnostic challenge

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