Correlation between the range of rotation of the hip and the radiographic signs of cam and pincer morphology in femoroacetabular impingement syndrome.

Andreza Maroneze Da Silva,Vivian Bertoni Xavier,Giancarlo Cavalli Polesello,Vera Lúcia Dos Santos Alves,Flávia Marques Nakatake

doi:10.1590/0100-3984.2021.0036

Abstract

ObjectiveTo determine whether hip rotation correlates with the radiographic signs of cam or pincer deformity after hip arthroscopy in patients with femoroacetabular impingement syndrome.Materials and MethodsThis was a single-center retrospective study of data collected between 2014 and 2017. The study sample included 65 patients between 18 and 55 years of age who underwent hip arthroscopy for the treatment of unilateral femoroacetabular impingement. The following data were collected for the periods prior to and six months after surgery range of medial and lateral rotation of the hip; measures on anteroposterior X-rays of the pelvis obtained in the standing position and on ateral X-rays in the Ducroquet profile view; and score on the 33-item International Hip Outcome Tool.ResultsMean preoperative and postoperative values were as follows: 19.26 ± 10.39° and 30.95 ± 3.52°, respectively, for medial rotation of the hip (p < 0.001); 73.85 ± 6.62° and 68.12 ± 5.04°, respectively, for the anteroposterior alpha angle (p < 0.001); 56.97 ± 6.09° and 50.61 ± 5.39°, respectively, for the lateral alpha angle (p < 0.001); and 0.17 ± 0.11 and 0.07 ± 0.08, respectively, for the acetabular retroversion index (p < 0.001). The crossover sign was identified in 75.4% of the patients before surgery and in 44.6% after (p < 0.001). Although there was an increase in the range of hip rotation and an improvement in radiographic parameters after arthroscopy, we detected no direct correlation between the two.ConclusionHip arthroscopy can improve medial rotation of the hip, as well as reducing cam and pincer deformities, in patients with femoroacetabular impingement syndrome. However, those findings do not appear to be directly correlated.

Highlights

Femoroacetabular impingement (FAI) syndrome is defined as a change in hip movement characterized by abnormal contact between the femoral head and the anterior aspect of the acetabulum
Treatment options for FAI syndrome have evolved over the last decade and can be classified as conservative or surgical, producing similar results, hip arthroscopy is favored in the short term[5]
Patients who had previously undergone lower-limb orthopedic surgery were excluded, as were those with osteoarthritis, osteonecrosis, or intraarticular hip tumors observed on imaging or arthroscopy, as well as those in whom the radiography protocol was inappropriate for the study and those for whom the clinical data were incomplete

Summary

Introduction

Femoroacetabular impingement (FAI) syndrome is defined as a change in hip movement characterized by abnormal contact between the femoral head and the anterior aspect of the acetabulum. Functional activities that require extreme ranges of movement can generate shear force, increasing stress on the acetabular labrum and cartilage[4]. Treatment options for FAI syndrome have evolved over the last decade and can be classified as conservative or surgical, producing similar results, hip arthroscopy is favored in the short term[5]. Surgical options include open and arthroscopic resection of bone deformities of the femur or acetabulum, as well as the management of associated soft-tissue lesions (of the labrum or cartilage). The arthroscopic technique is safe, requires less recovery time, and produces consistent results in the short and medium term[6]

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Conclusion