Abstract
BackgroundFemoroacetabular impingement (FAI) is caused by an anatomic deviation of the acetabular rim or proximal femur, which causes chronic groin pain. Radiological identification of FAI can be challenging. Advances in imaging techniques with the use of computed tomography (CT) scan enable 3D simulation of FAI. We made an experimental cadaveric validation study to validate the 3D simulation imaging software.MethodsThe range of motion (ROM) of five cadaveric hips was measured using an electromagnetic tracking system (EMTS). Specific marked spots in the femur and pelvis were created as reproducible EMTS registration points. Reproducible motions were measured. Hips were subsequently imaged using high-resolution CT after introduction of artificial cam deformities. A proprietary software tool was used, Articulis (Clinical Graphics) to simulate the ROM during the presence and absence of the induced cam deformities.ResultsAccording to the EMTS, 13 of the 30 measured ROM end-points were restricted by > 5° due to the induced cam deformities. Using Articulis, with the same 5° threshold, we correctly detected 12 of these 13 end point limitations and detected no false positives. The median error of the measured limitations was 1.9° (interquartile range 1.1° - 4.4°). The maximum absolute error was 5.4°.ConclusionsThe use of this dynamic simulation software to determine the presence of motion limiting deformities of the femoroacetabular is validated. The simulation software is able to non-invasively detect a reduction in achievable ROM, caused by a cam type deformity.
Highlights
Femoroacetabular impingement (FAI) is caused by an anatomic deviation of the acetabular rim or proximal femur, which causes chronic groin pain
The aim of this study was to validate a computed tomography (CT)-based motion simulation software method that has already been validated for other joints [16,19], in the context of FAI, and to evaluate the method’s applicability for the diagnostic work-up of FAI in a prospective cohort followup study of FAI patients
We correctly detected 12 of the 13 end point limitations compared to the electromagnetic tracking system (EMTS) as the gold standard for measurements of range of motion (ROM)
Summary
Femoroacetabular impingement (FAI) is caused by an anatomic deviation of the acetabular rim or proximal femur, which causes chronic groin pain. Advances in imaging techniques with the use of computed tomography (CT) scan enable 3D simulation of FAI. Femoroacetabular impingement (FAI) is an accepted etiology of premature osteoarthritis of the non-dysplastic hip [1]. It has predominance for males, with a prevalence of 17% in men and 4% in women [2,3]. The arthroscopic method has a lower complication rate and functional results of this procedure have been described as good [4,5,6,7].
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