Hip Joint Kinematic Covariation During Gait Before and 1-Year After Hip Arthroscopic Surgery for Femoroacetabular Impingement Syndrome.

Philip Malloy,Donald Dr Neumann,Anne Leung,Kristof Kipp

doi:10.3389/fsurg.2021.614329

Philip Malloy, Donald Dr Neumann + Show 2 more

Open Access

https://doi.org/10.3389/fsurg.2021.614329

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Abstract

The primary aim of this study was to determine if the three-dimensional (3D) hip joint motion coordination during gait changes after arthroscopic surgery for femoroacetabular impingement syndrome (FAIS). Three-dimensional hip joint kinematic data were collected with a 12-camera motion capture system. Five trials of level walking were collected preoperatively (PRE) and at 1-year postoperatively (POST) in 8 patients diagnosed with FAIS and at a single time point in 8 healthy controls. Planar covariation analysis was performed to quantify the 3D hip joint motion coordination strategy during gait. Independent sample's t-test were used to determine differences between the FAIS group at the preoperative time point (PRE) and healthy controls. Paired samples t-tests were used to determine differences between the PRE and POST time points within the FAIS group. The %VAF by PC 1 for the FAIS group at the PRE time point was significantly less than that of healthy controls (PRE: 77.2 ± 8.7% vs. Control: 96.1 ± 2.8%; p = 0.0001), and the % VAF of the second PC (PC2) was significantly greater [PRE: 22.8 (8.7)%; Control: 3.9 (2.8)%; p = 0.0001]. No differences in %VAF were found between the PRE and POST time points within the FAIS group for PC1 [PRE: 77.2 (8.7)% vs. POST: 79.3 (11.1)%; p = 0.472] or PC2 [PRE: 22.7 (8.7)%; POST: 20.7 (11.1)%; p = 0.472]. Significant differences in the plane specific contribution to the 3D motion coordination strategy were found between the FAIS patients at the PRE and POST time points for the sagittal plane [PRE: 5.6 (2.7) vs. POST: 0.91 (6.1); p = 0.012] and frontal plane [PRE: −10.4 (2.2) and −1.5 (6.3); p = 0.005]. Patients with FAIS demonstrated a more complex coordination strategy of 3D hip joint motion than controls and this strategy remains unchanged after hip arthroscopic surgery despite changes in the plane specific contribution to this strategy. These findings indicate that motor control impairments in FAIS patients do exist and seem to persist for at least 1 year after hip arthroscopic surgery.

Highlights

Femoroacetabular impingement syndrome (FAIS) causes hip related groin pain and is associated with abnormal bone shape of the proximal femur and/or acetabulum [1]
Six patients undergoing hip arthroscopy were diagnosed with cam type morphology (n = 6) whereas 2 patients were diagnosed with mixed cam and pincer morphology (n = 2)
After hip arthroscopic surgery for FAIS, patients did demonstrate differences the amount that the sagittal and frontal planes contributed to PC1 of the overall 3D hip joint kinematic covariation strategy, which was indicated by the difference in PC1 scores for these planes

Summary

Introduction

Femoroacetabular impingement syndrome (FAIS) causes hip related groin pain and is associated with abnormal bone shape of the proximal femur and/or acetabulum [1]. This abnormal bone shape can cause symptomatic contact between the femur and acetabulum during normal hip motion, and has been implicated in the development of hip osteoarthritis (OA) through altered mechanical joint loading [1]. The rationale behind hip arthroscopy for FAIS is to reshape the proximal femur and/or acetabulum by removing the abnormal bone to restore joint congruence and biomechanics at the hip joint during function tasks. The evidence remains limited on how hip arthroscopy influences joint level biomechanical function in patient with FAIS [6]

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