Abstract
BackgroundsThis study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome.Materials and methodsBetween 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp’s acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study.ResultsOn hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp’s angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp’s angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4).ConclusionThe results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms.Level of evidenceLevel III.
Highlights
The hip impingement syndrome is generally classified into two categories
The minimum ischio-femoral distance measured using CT was significantly decreased in the ischiofemoral impingement (IFI) symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4)
The results suggest that the characteristic deformities represented by coxa valga in the multiple hereditary exostoses patients (MHE) hip act as an offset for femoro-acetabular impingement (FAI) symptoms, on the contrary, act as a trigger for IFI symptoms
Summary
Femoro-acetabular impingement (FAI), is already established as an intra-articular condition creating abnormal conflict between the acetabulum and femoral head-neck junction area. Over time, these kinds of frictions can damage the joint, causing pain and limiting activity [1]. Studies have reported that the dominant cause of IFI syndrome is the narrowing of the space between the ischial tuberosity and the lesser trochanter area, which can cause abnormal contact of the quadratus femoris muscle [2–5, 12, 13]. Studies on IFI syndrome have been conducted recently, this syndrome has not been reported as much as FAI in general population
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
