Abstract
IntroductionDiscerning whether range of motion (ROM) is restricted by morphology or other pain sources is challenging in patients with femoroacetabular impingement syndrome (FAIS). Computed tomography (CT) motion simulation provides a hypothetical ROM based on morphology. This study aimed to explore associations between ROM measured using CT motion simulation and maximum passive ROM measured clinically using three dimensional (3D) motion analysis in patients with FAIS, prior to and post arthroscopic hip surgery.Materials and methodsEight males with FAIS (in total 12 hip joints) were included in this explorative feasibility study. Participants were examined using CT according to a low-dose protocol prior to and 7-months post arthroscopic surgery. Software was used to simulate at which ROM the impingement would occur. With the hip in 90 degrees’ flexion, maximum passive range of internal hip rotation, and maximum passive internal hip rotation coupled with adduction was examined clinically using 3D motion analysis pre- and postoperatively. Spearman rank correlation coefficients and linear regressions examined associations between methods.ResultsPreoperatively, the correlation between maximum internal hip rotation measured using CT motion simulation and 3D motion analysis was strong (r = 0.71, p = 0.009). Linear regressions demonstrated that maximal internal rotation measured using CT motion simulation was predominantly larger than when measured using 3D motion analysis. Postoperatively, and when maximum internal rotation was coupled with adduction, no correlations were found between the two methods.ConclusionsThe hypothetical morphology restricted ROM is larger than clinically assessed pain restricted ROM, both prior to and post hip arthroscopy. These findings suggest that ROM is restricted by pain rather than mechanical, morphology-based impingement in individuals with FAIS.
Highlights
Discerning whether range of motion (ROM) is restricted by morphology or other pain sources is challenging in patients with femoroacetabular impingement syndrome (FAIS)
Surgical resection of cam impingement was performed in all 12 examined hip joints, and surgical resection of pincer impingement was performed in three hip joints (Table 2)
Linear regressions demonstrated that maximum internal rotation measured using Computed tomography (CT) motion simulation was predominantly larger than when measured using 3D motion analysis (Table 4, Figs. 2 and 3)
Summary
Discerning whether range of motion (ROM) is restricted by morphology or other pain sources is challenging in patients with femoroacetabular impingement syndrome (FAIS). This study aimed to explore associations between ROM measured using CT motion simulation and maximum passive ROM measured clinically using three dimensional (3D) motion analysis in patients with FAIS, prior to and post arthroscopic hip surgery. Conclusions The hypothetical morphology restricted ROM is larger than clinically assessed pain restricted ROM, both prior to and post hip arthroscopy These findings suggest that ROM is restricted by pain rather than mechanical, morphology-based impingement in individuals with FAIS. Refers to a cam effect initiated by a non-spherical femoral head rotating inside the acetabulum [1], while pincer impingement involves focal or general over coverage by the acetabulum of the femoral head [2] During movement this mismatch may lead to joint friction and reduced range of motion (ROM) [1, 3, 4]. The specificity for radiographic imaging signs in predicting risk for developing FAIS is poor, since cam changes have been documented in 55% of asymptomatic athletes and 23% in an asymptomatic general population [6, 7]
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