Signs Of Femoroacetabular Impingement Research Articles

Natural Course of Early Radiological Signs of Femoroacetabular Impingement in An Asymptomatic Population

Natural Course of Early Radiological Signs of Femoroacetabular Impingement in An Asymptomatic Population

Are "normal hips" being labeled as femoroacetabular impingement due to EE angle?

Gluteal muscle contracture (GMC) is a clinical syndrome characterized by gait abnormality and limb dysfunction, as well as secondary deformities of pelvis and femur. Femoroacetabular impingement (FAI) typically could be diagnosed on the basis of computed tomography (CT) such as the equatorial-edge angle (EE angle), but it did not work well in GMC patients. In this study, we retrospected all image data and found small EE angles in GMCs, which meant retroverted acetabulum; however, none of them showed no symptoms and signs of FAI. Therefore, we had reasons to think that, some normal hips with unbalanced hip myodynamia as same as GMCs, may be incorrectly diagnosed as FAI through measuring EE angle only.In consequence, the paper was designed to assess the use of the EE angle in the assessment of FAI in the diagnosis, as described by Werner.Twenty-three patients (46 hips) were collected and calculated with the “equatorial-edge angle” (EE angle) by CT scans. All of them were excluded from FAI.Review of the hips showed a mean EE angle was 12.93°, with a minimum of -3.42° and a maximum of 24.08°. The mean value for males and females were 13.52° and 12.40°, respectively, without statistical significance, although the mean value of left hips and right sides reached 13.32° and 12.54° individually, not having statistical differences neither. There were not any symptoms or signs of FAI in all patients. Thus, the reduced EE angle could suggest the local excessive coverage of the femoral head by the anterior acetabular edge, but might not be a reasonably good predictor of FAI.GMC patient's acetabular deformity mainly manifests as increased retroversion, which may be the anatomical basis for FAI and lead to high risks of the acetabular impingement. However, all patients in this study showed no symptoms and signs of FAI, suggesting that the measurement of EE angle can only be applied to assessing those people with normal hip myodynamia, and the bone deformity and the muscular disorder should be both considered in the diagnosis of FAI.

Retrospective Analysis of Idiopathic Hip Osteoarthritis Based on Anteroposterior Pelvic Radiograph; Hip Osteoarthritis Caused by Femoroacetabular Impingement

Background: Femoroacetabular Impingement (FAI) means pathological impact between the femoral head-neck junction and the acetabular rim. Objectives: The aim of this retrospective study was to analyze Femoroacetabular Impingement (FAI) signs, which can lead to idiopathic hip osteoarthritis, from preoperative radiographs of patients indicated for total hip replacement as compared to radiographs of patients without this indication. Methods: We examined the preoperative anteroposterior (AP) pelvic radiograph, the pincer and cam FAI signs of patients between 45 and 60 years, who had undergone total hip replacement. We examined in the same group, the operated side and the non-operated hips with osteoarthritis (patients group). In the control group we examined the pelvic radiograph of patients without symptoms between 45 and 60 years old (control, group). Results: In the patient group (215 patients, 313 hips) we noted the signs of FAI in 88% while in the control group (112 patients 224 hips) these signs were found in 8.8% of cases. Conclusions: In 88% of primary osteoarthritis cases we found FAI morphology on the AP pelvic radiograph, similarly to those found in the bibliography, and we considered naming primary osteoarthritis, secondary osteoarthritis caused by FAI. In the majority of cases, early diagnosis with simple, cheap and easily accessible AP pelvic radiograph with low dose of radiationmay also be warranted

Long-term Evolution of Slipped Capital Femoral Epiphysis Treated by in Situ Fixation: A 26 Years Follow-up of 11 Hips.

Slipped capital femoral epiphysis (SFCE) may lead to femoro acetabular impingement and long-term function impairment, depending on initial displacement and treatment. There are several therapeutic options which include in situ fixation (ISF). The objective of this study was to evaluate long-term functional and radiographic outcomes of patients with SFCE treated with ISF. We conducted a single-center, retrospective study evaluating the clinical and radiographic outcomes of SCFE in situ fixation with a mean follow-up of 26 years (10-47). Analysis of preoperative and last follow up radiographs was performed. The functional status of the hip was evaluated according to the Oxford hip score-12 and the radiographic osteoarthritis stage was rated according to Tönnis classification. Signs of femoro acetabular impingement were sought. Ten patients (11 hips) were included. The average initial slip was 33.5° (10-62). At final follow up, the average Oxford hip score was 19.3 (12-37), it was good for groups who had a small initial slip (16.7) or moderate (17) and fair for the severe group (27). Average Tönnis grade was 1.3 (0-3). The average alpha angle was 65.3° (50-80°). Femoro acetabular impingement was likely in 100% of patients with severe slip, in 50% of patients with moderate slip and in 33% of patients with a slight slip. In situ fixation generated poor functional results, substantial hip osteoarthritis and potential femoro acetabular impingement in moderate to severe SCFE’s. However, in cases with minor displacement, functional and radiographic results are satisfactory. The cut off seems to be around 30° slip angle, above which other treatment options should be considered.

Early clinical results of surgical treatment of patients with femoroacetabular impingement

Surgical treatment is the treatment of choice in patients with symptoms and radiological signs of femoroacetabular impingement. Our experience and early results of surgical treatment of patients with signs of femoroacetabular impingement and early hip osteoarthritis are reported. The results of treatment of 21 patients aged 23-54 years with different types of femoroacetabular impingement are presented. Safe open surgical dislocation of the hip was performed in all patients. Before and after surgery, the WOMAC score was performed, clinical and radiographic data of the operated hips were evaluated and t-tests were used for statistical analyzes of data. The WOMAC score improved from 70.5 points (range 56.3 to 89.8 points) to 90.3 points (range 70.3 to 100 points) at one year of follow-up (p < 0.0001), anterior impingement test was negative in all operated cases, average hip internal rotation improved significantly, no complications were found, except trochanteric nonunion at the site of osteotomy, which was reaffixed. Postoperative results have shown that the surgical approach to treating patients with femoroacetabular impingement is the method of choice. Three operated patients, with advanced osteoarthritis of the hip, had to be converted to total hip replacement.

Coxarthrosis and periarticular pathology of the hip: clinical manifestations, diagnosis, approaches to therapy

Osteoarthrosis (OA) is the most common joint disease affecting both men and men. There is primary and secondary OA. Up to now, the causes of primary OA remain unclear. Secondary OA is associated with the presence of joint injury in the history, with congenital anomalies of the structure, metabolic diseases, endocrinopathies, etc. It is particularly difficult to interpret coxarthrosis if there are signs offemoroacetabular impingement. Periarticular pathology plays an important role in the origin of the hip pain syndrome that accompanies or mimics the symptoms of coxarthrosis. The main goals of OA therapy are to slow down the progression of cartilage degeneration and to maintain joint function as much as possible. Combination drugs containing chondroitin sulfate and glucosamine hydrochloride are widely used to treat OA today.

Case Reports: Fractures of Threaded Cups: Rare Complications of a Well-established Implant

The use of cementless threaded cups in THA is a well-established treatment. Fractures of the cups are rare complications recorded in individual cases with material defects being discussed as the primary cause. We analyzed three cases of fractured cups. Although all three cups were well fixed to existing bone, we observed deficient osseous backing dorsocranially and abrasion particles. There were no signs of femoroacetabular impingement or infection. The cups showed corrosion debris. Scanning electron microscopic investigations showed characteristics of fretting and fretting-related corrosion. We concluded the fractures occurred because of fretting combined with inadequate bony support leading to fatigue of the material and subsequent fracture.