The acetabular rim syndrome. A clinical presentation of dysplasia of the hip

Klaue, Kaj; Cw, Durnin; Ganz, Reinhold

doi:10.1302/0301-620x.73b3.1670443

Cited by 723 publications

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“…The control subjects with elevated (C 55°) alpha angles also showed a larger mean omega zone of 20% (95% CI, 18-22; p = 0.004) and 16% (95% CI, 13-19; p = 0.007) for 60°and 90°of flexion, respectively, compared with the patients with FAI. Furthermore, the mean omega zone at 0°a nd 30°was larger with 23% (95% CI, 19-27; p = 0.017) and 22% (95% CI, 19-26; p = 0.004), respectively, whereas the mean omega zone in patients with FAI was 18% (95% CI, [15][16][17][18][19][20][21][22] and 16% (95% CI, [11][12][13][14][15][16][17][18][19][20] (Table 3). In contrast, the omega zone was similar in both control groups at any of the flexion positions (0°p = 0.806, 30°p = 0.925, 60°p = 0.345, 90°p = 0.136).…”

Section: Resultsmentioning

confidence: 99%

“…The diagnosis of cam-type FAI was made by three experienced clinicians (EA, RMB, TH) based on patient history, a positive impingement test on clinical examination [13], and/or radiographic signs of cam impingement (alpha C 60°in 11, alpha [ 55°in two patients), and/or arthroscopy. The included patients were derived from a total of 31 patients with FAI who were analyzed with CT scans in the clinician's practice over a 3-month period.…”

Section: Patients With Femoroacetabular Impingementmentioning

confidence: 99%

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Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Bouma

Hogervorst

Audenaert

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Femoroacetabular impingement (FAI) presupposes a dynamic interaction of the proximal femur and acetabulum producing clinical symptoms and chondrolabral damage. Currently, FAI classification is based on alpha angle and center-edge angle measurements in a single plane. However, acetabular and femoral version and neck-shaft angle also influence FAI. Furthermore, each of these parameters has a reciprocal interaction with the others; for example, a shallow acetabulum delays impingement of the femoral head with the acetabular rim. Questions/purposes We introduce the new parameter ''omega zone,'' which combines five parameters into one: the alpha and center-edge angles, acetabular and femoral version, and neck-shaft angle. We sought to determine whether the omega zone could differentiate patients with FAI from (1) normal control subjects (alpha \ 55°), but also from (2) control subjects with elevated alpha angles (C 55°). Methods We evaluated CT data of 20 hips of male patients with symptomatic cam-type FAI and of 35 male hips extracted from 110 anonymized CT scans for vascular diagnosis. We excluded hips with osteoarthritis, developmental dysplasia, or coxa profunda (center-edge angle 20°-45°on AP pelvic view or corresponding coronal CT views). With dedicated software, femoral and pelvic orientation was standardized; we tested the omega zone in four hip positions in three distinct groups: patients with cam-type FAI (alpha [ 60°) and control subjects with normal (\ 55°) and high alpha angles (C 55°). Results The omega zone was smaller in patients with cam-type FAI than normal control subjects (alpha angle \ 55°) at 60°and 90°of flexion (mean, 12%; 95% confidence interval [CI], 7-17; p = 0.008; Cohen's d = 9%; 95% CI, 4-13; p = 0.003). Furthermore, the omega zone was smaller in all positions in patients with cam-type FAI than control subjects with high alpha angles (0°p = 0.017, 30°p = 0.004, 60°p = 0.004, 90°p = 0.007). In contrast, the omega zone did not differ between control subjects with normal or high alpha angles. In all hips, the omega zone decreased with flexion, corresponding to a decrease in remaining impingement-free motion with flexion.

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Section: Resultsmentioning

confidence: 99%

Section: Patients With Femoroacetabular Impingementmentioning

confidence: 99%

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Bouma

Hogervorst

Audenaert

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Chondrolabral damage in the hip most commonly occurs on the anterosuperior acetabular rim [2,10,11,13,15,17,23]. This is true for damage from both FAI and dysplasia.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, classic acetabular dysplasia involves lateral and anterior undercoverage, causing static overload on the anterior and superior rim in stance with resultant anterosuperior rim damage [15]. Anteroinferior acetabular chondrolabral pathology has been observed in series evaluating the diagnostic effectiveness of MR arthrography [31,38].…”

Section: Discussionmentioning

confidence: 99%

“…Most labral abnormalities in patients with either femoroacetabular impingement (FAI) or dysplasia are anterosuperior or directly anterior [2,10,11,13,15,17,23]. Impingement and instability can, however, occur circumferentially around the acetabular rim [2,11] and can also be initiated extraarticularly, causing secondary intraarticular damage [5,9,14].…”

Section: Introductionmentioning

confidence: 99%

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Case Reports: Anteroinferior Acetabular Rim Damage Due to Femoroacetabular Impingement

Tibor¹,

Ganz

Leunig

2013

Clinical Orthopaedics &Amp; Related Research

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Background The most common location of labral tears and chondral damage in the hip is the anterosuperior region of the acetabulum, which is associated with pain in flexion and rotation. We describe a case series of patients with labral tears, ganglion formation, and chondromalacia isolated to the anteroinferior acetabulum. Clinically, patients had pain in extension and internal rotation. Case Descriptions Isolated anteroinferior labral hypertrophy and ganglion were first observed in a patient with coxa valga. We retrospectively reviewed clinical and radiographic records and identified nine hips in seven patients with isolated anteroinferior damage. One patient with bilateral valgus femoral head tilt after slipped capital femoral epiphysis (SCFE) had impingement of the anteromedial metaphysis on the acetabulum from 3 to 6 o'clock.

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Impairment Tutorial: Rating Tears of the Acetabular Labrum

Brooks¹,

Strain²,

Talmage³

2006

AMA Guides® Newsletter

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The primary function of the acetabular labrum, like that of the glenoid, is to deepen the socket and improve joint stability. Tears of the acetabular labrum are common in older adults but occur in all age groups and with equal frequency in males and females. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, is silent about rating tears, partial or complete excision, or repair of the acetabular labrum. Provocative tests to detect acetabular labrum tears involve hip flexion and rotation; all rely on production of pain in the groin (typically), clicking, and/or locking with passive or active hip motions. Diagnostic tests or procedures rely on x-rays, conventional arthrography, computerized tomography, magnetic resonance imaging (MRI), magnetic resonance arthrography (MRA), and hip arthroscopy. Hip arthroscopy is the gold standard for diagnosis but is the most invasive and most likely to result in complications, and MRA is about three times more sensitive and accurate in detecting acetabular labral tears than MRI alone. Surgical treatment for acetabular labrum tears usually consists of arthroscopic debridement; results tend to be better in younger patients. In general, an acetabular labral tear, partial labrectomy, or labral repair warrants a rating of 2% lower extremity impairment. Evaluators should avoid double dipping (eg, using both a Diagnosis-related estimates and limited range-of-motion tests).

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The acetabular rim syndrome. A clinical presentation of dysplasia of the hip

Cited by 723 publications

References 0 publications

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Can Combining Femoral and Acetabular Morphology Parameters Improve the Characterization of Femoroacetabular Impingement?

Case Reports: Anteroinferior Acetabular Rim Damage Due to Femoroacetabular Impingement

Impairment Tutorial: Rating Tears of the Acetabular Labrum

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