Source Of Hip Pain Research Articles

Ligamentum teres reconstruction using autogenous semitendinosus tendon with toggle technique in rabbits.

Ligamentum teres (LT) has traditionally been considered a vestigial or redundant structure in humans; however, based on new studies and the evolution of hip arthroscopy, the LT injury has been viewed as a source of hip pain. Therefore, LT reconstruction can be beneficial in some cases. Rabbits have been frequently used as a model for cranial cruciate ligament reconstruction but few studies are available for ligamentum teres reconstruction. To evaluate the semitendinosus tendon to replace ligamentum teres with the toggle technique, using rabbits as an experimental model. Twenty-six female Norfolk rabbits with approximately 3 months of age were divided into two equal groups after excision of ligamentum teres (LT) from the right hip joint: G1-no reconstruction of LT and capsulorrhaphy; G2-double-bundle reconstruction of the LT using semitendinosus tendon autograft. In both groups, the LT was removed from the right hip joint. In G2 the autograft was harvested from the left hind limb of the same rabbit. The rabbits were evaluated clinically at different time intervals; before surgery (M1), 48 h (M2), 15 days (M3), 30 days (M4) and 90 days (M5) after surgery. The rabbits supported their limbs on the ground in both the groups. As complications of the procedure, four hip joints showed subluxations in the radiographic evaluation of G1; three at M4 and one at M5. In G2; two luxations of hip joints at M3 and one subluxation at M4 were seen. On ultrasound, irregular articular surface was seen in 30.8% of the rabbits that had subluxation of hip joints. Gross evaluation identified tendon graft integrity in 76.92% of the rabbits. Histological analysis revealed graft adhesion to the bone in the early phase comprised of sharpey-like collagen fibers. The double-bundle reconstruction of the LT using autologous semitendinosus tendon associated with the toggle rod shows an early phase of tendon graft ligamentization at 90 days post-operatively in young rabbits, but biomechanical bias suffered by the tendon during gait must be considered.

Evaluation of additional causes of hip pain in patients with femoroacetabular impingement syndrome.

Femoroacetabular impingement syndrome (FAIS) is an increasingly prevalent pathology in young and active patients, that has contributing factors from both abnormal hip morphology as well as abnormal hip motion. Disease progression can be detrimental to patient quality of life in the short term, from limitations on sport and activity, as well as the long term through early onset of hip arthritis. However, several concurrent or contributing pathologies may exist that exacerbate hip pain and are not addressed by arthroscopic intervention of cam and pincer morphologies. Lumbopelvic stiffness, for instance, places increased stress on the hip to achieve necessary flexion. Pathology at the pubic symphysis and sacroiliac joint may exist concurrently to FAIS through aberrant muscle forces. Additionally, both femoral and acetabular retro- or anteversion may contribute to impingement not associated with traditional cam/pincer lesions. Finally, microinstability of the hip from either osseous or capsuloligamentous pathology is increasingly being recognized as a source of hip pain. The present review investigates the pathophysiology and evaluation of alternate causes of hip pain in FAIS that must be evaluated to optimize patient outcomes.

Arthroscopic Ischial Tuberoplasty: Treatment of Ischiofemoral Impingement

Background: Ischiofemoral impingement is a rare but increasingly recognized as a source of hip pain. Its etiology is often multifactorial and can be due to congenital, iatrogenic, or extra-articular pathology. Prior literature has described lesser trochanter osteoplasty and iliopsoas release for the treatment of ischiofemoral impingement, but postoperative hip flexor weakness has been noted with this technique. We present a novel technique for the treatment of ischiofemoral impingement, with resection of the ischial tuberosity. Indications: Patients with ischiofemoral impingement that remain symptomatic despite nonsurgical management, or patients with persistent gait abnormalities, are considered for surgery. Technique Description: In the prone position, direct posterior and posterolateral arthroscopic portals are created in the gluteal fold. The posterior femoral cutaneous and sciatic nerve are identified. Fluoroscopy is used to identify the region of impingement on the ischial tuberosity and the overlying hamstring tendon is elevated off the tuberosity. An arthroscopic burr is used to resect the tuberosity. Fluoroscopy is utilized to confirm adequate resection. This is combined with a dynamic examination under direct arthroscopic visualization with the hip in an extended, adducted, and externally rotated position. To repair the hamstring tendon, 2 double-loaded anchors are placed into the ischium, the sutures of which are used to repair the hamstring tendons using a horizontal mattress configuration. Patients undergo a stepwise postoperative physical therapy protocol, followed by a functional testing profile prior to return to competitive sport. Results: Significant improvements in patient-reported outcomes have been reported following treatment of ischiofemoral impingement, with some studies reporting Hip Outcome Score—Activities of Daily Living (HOS-ADL) >90 at 2 years postoperatively. Athletes have been able to return to sport at a mean 5.6 months after surgery. Large studies have yet to report on outcomes compared with nonsurgical or open techniques. Discussion/Conclusion: Recent advancements in endoscopic techniques have allowed for adequate visualization and release of ischiofemoral impingement. We present our endoscopic technique of ischial tuberoplasty, which, compared to lesser trochanter osteoplasty and iliopsoas release, may reduce the incidence of postoperative hip flexor weakness.

The efficacy of intra-articular HYADD4-G injection in the treatment of femoroacetabular impingement: results at one year follow up

Objective Femoroacetabular impingement (FAI) is a condition that has been increasingly recognized as a source of hip pain and a possible risk factor to early development of hip osteoarthritis (OA). To our knowledge, the use of HA in the treatment of femoroacetabular FAI has been investigated only by two studies, both using a high molecular weight HA. The aim of this study was to evaluate the efficacy of two weekly injections of an hexadecylamide derivative of HA (HYADD4-G, HYMOVIS, Fidia Farmaceutici) in FAI. Methods All patients received two weekly intra-articular injections of Hymovis at baseline and after 7 days. Clinical and functional assessments were performed at baseline and was repeated after 1, 3, 6 and 12 months. Functional measures included visual analogue scale (VAS) for pain, Harris Hip score (HHS), Lequesne Index (LI), Tegner activity level scale (TALS) and monthly consumption of nonsteroidal anti-inflammatory drugs (NSAIDs). Results Twenty-one hips (19 patients, 2 bilateral cases) were treated. The variables VAS, HHS as well as Lequesne improved significantly from T0 to T4 (at 12 months) with the best improvement between T0 and T1. At the same time, a reduction in NSAIDs monthly intake was registered. On the other hand, a significant improvement in Tegner scale was not observed. No adverse events were registered. Conclusion This study states that one cycle of HYADD4-G could be a safe and effective treatment in patients with FAI, showing significative results in term of pain control as well as hip functionality and quality of life up to 1 year.

Value of response to anesthetic injection during hip MR arthrography to differentiate between intra- and extra-articular pathology.

To determine the value of anesthetic injection during hip MR arthrography (anesthetic MRA) to differentiate between intra- and extra-articular pathology in patients with hip pain. This retrospective study was IRB-approved and HIPAA-compliant. We included 75 consecutive adult patients (46 women, mean age 38 ± 13years) who were referred for MRA. All patients underwent a focused hip examination including active flexion, passive flexion, and passive flexion with internal and external rotation, immediately prior to injection. Anesthetic MRA was performed following fluoroscopically guided intra-articular injection of contrast mixed with anesthetic. Following the injection, the hip examination was repeated, and the pain response was recorded. Clinical records, including response to corticosteroid injections, physical therapy notes, and operative reports were reviewed for verification of intra- and extra-articular pathology as the source of hip pain (gold standard). The positive (PPV) and negative predictive values (NPP) of anesthetic MRA to differentiate between intra- and extra-articular pathology were calculated. On MRI, 41 patients had only intra-articular and 5 patients only extra-articular pathology, while 29 patients had both, intra- and extra-articular pathology. Forty-three patients had pain relief and 32 patients had no pain relief after anesthetic injection. PPV of anesthetic MRA to detect intra-articular pathology was 91% and NPV was 67%. Anesthetic MRA can be used as an adjunct to define the origin of hip pain. A positive response suggests intra-articular pathology which can be helpful to localize the source of pain in equivocal cases where both intra- and extra-articular pathology are evident on MRI.

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Subspine impingement has been increasingly recognized as a source of hip pain over the past 5 to 10 years. Some surgeons routinely perform subspine/anterior inferior iliac spine (AIIS) decompressions, whereas others rarely perform these procedures as part of an arthroscopic hip procedure. Subspine impingement has been implicated with high range-of-motion activities, various AIIS morphologies and deformities, and in the setting of persistent anterior hip pain after intra-articular anesthetic injections. Dynamic computed tomographic imaging has recently shown subspine impingement even with relatively normal AIIS morphology and in the setting of decreased femoral anteversion. These findings further emphasize the importance of understanding and defining relationships between morphology and impingement. Ultimately, subspine decompressions might be critical to achieve the best possible outcome after arthroscopic hip procedures in a subset of patients, but making the diagnosis remains challenging for clinicians.

Does virtual reality rehabilitation influence postural control after total Knee replacement?

Subspine impingement has been increasingly recognized as a source of hip pain over the past 5 to 10 years. Some surgeons routinely perform subspine/anterior inferior iliac spine (AIIS) decompressions, whereas others rarely perform these procedures as part of an arthroscopic hip procedure. Subspine impingement has been implicated with high range-of-motion activities, various AIIS morphologies and deformities, and in the setting of persistent anterior hip pain after intra-articular anesthetic injections. Dynamic computed tomographic imaging has recently shown subspine impingement even with relatively normal AIIS morphology and in the setting of decreased femoral anteversion. These findings further emphasize the importance of understanding and defining relationships between morphology and impingement. Ultimately, subspine decompressions might be critical to achieve the best possible outcome after arthroscopic hip procedures in a subset of patients, but making the diagnosis remains challenging for clinicians.

Femoroacetabular Impingement in the Adolescent Athlete

Femoroacetabular impingement syndrome (FAIS) is a source of hip pain that can present in adolescent athletes and is related to sports participation and extreme use in these patients. FAIS is characterized by morphologic abnormalities of the acetabulum and/or proximal femur that leads to pathologic contact within the hip joint. FAIS is classified as cam-type, pincer-type, or combined. Early sports participation is a factor in the development of symptomatic FAIS. Adolescent patients with FAIS are also more likely to have associated extra-articular pathologies. History and physical exam findings in adolescents with FAIS are not considerably different than corresponding findings in adults with FAIS and include activity-related groin pain aggravated by pivoting and flexion activities. FAIS can be treated conservatively or surgically. In refractory cases, outcomes after surgical intervention have been shown to be significantly better than nonsurgical treatment. Surgical intervention involves repairing damage to the labrum and/or cartilage and decompressing the bony impingement. Open and arthroscopic approaches have been shown to be safe and effective in adolescents with good outcomes. Most adolescent athletes are able to return to participation in their sport and a majority returning to their preinjury level of play after surgical intervention.

Hip Injuries in Endurance Athletes: The Runner and Cyclist

Running and cycling have become among the top athletic activities in the United States. While endurance sports can lead to decreased cardiovascular disease and chronic comorbidities, it can lead to musculoskeletal injury. Hip injuries in endurance athletes can be associated with both intra-articular and extra-articular disorders, resulting in prolonged decrease physical function and inability to return to sport. This review provides physicians with a summary of hip injury commonly presented in long distance runners and cyclist, as well as clinical exam recommendations for the source of hip pain in these endurance athletes.

Improvement in Functional Outcome Scores Despite Persistent Pain With 1 Year of Nonsurgical Management for Acetabular Labral Tears With or Without Femoroacetabular Impingement

Background: Acetabular labral tears are increasingly recognized as a source of hip pain in a younger active population. Given the significant focus on surgical intervention, there has been limited investigation on the nonsurgical management and natural history of such injuries. Hypothesis: Patients undergoing nonsurgical treatment for symptomatic acetabular labral tears experience functional improvement based on patient-reported outcome measures over the course of 1 year. Study Design: Case series; Level of evidence, 4. Methods: Seventy-one patients were identified who had acetabular labral injuries confirmed by magnetic resonance imaging or arthrography, received a minimum of 1 year of nonsurgical treatment, and completed baseline functional outcome questionnaires: modified Harris Hip Score (mHHS), Hip Outcome Score (HOS)–Activities of Daily Living, HOS-Sports, and iHOT-33 (International Hip Outcome Tool–33). Of these, 52 (73.2%) completed the minimum 1-year follow-up questionnaires. Chart review was conducted to obtain demographic information. Statistical significance (P < .05) was determined by paired t test, independent samples t test, and chi-square test. Results: Twenty-two male and 30 female patients completed 1-year follow-up questionnaires. Mean ± SD follow-up time was 16.2 ± 3.1 months. The cohort had a mean age of 38.9 ± 9.3 years. Baseline radiographs demonstrated minimal arthritis (Tönnis grades 0-2). Mean alpha angle differed significantly between men and women at 52.9°± 8.6° and 46.3°± 8.5°, respectively. At 1-year follow-up, patients experienced a significant improvement in all 4 functional outcome measures (mHHS: 72.6 vs 81.8, HOS–Activities of Daily Living: 78.6 vs 86.4, HOS-Sports: 56.0 vs 71.1, iHOT-33: 47.5 vs 67.9). Patients with and without femoroacetabular impingement demonstrated a significant improvement in the mHHS. However, 48.1% reported no improvement in their pain; 69.2% were limited in their activities; and 40.4% were still considering surgery. Overall, 71.2% were satisfied with nonsurgical treatment. Conclusion: Patients with symptomatic labral tears can experience functional improvement after a minimum 1 year of nonsurgical treatment in the presence and absence of femoroacetabular impingement. However, many report residual pain, alteration of their activities, and interest in surgery. This information is important when patients are counseled in the treatment options for this injury. Identifying the population that responds best to nonsurgical management and comparing outcomes with those undergoing surgical management should be the focus of future research. Longer-term follow-up may be necessary to reevaluate pain, function, and return to activities.

Predictors of Outcomes of Non-Surgical Management for Acetabular Labral Tears

Objectives:Acetabular labral tears are increasingly recognized as a source of hip pain in the younger, active population. Due to a significant focus on surgical intervention, there has been limited investigation on the predictive factors and natural history of non-surgical management of these injuries. Many reports recommend a trial of non-operative management with a variety of modalities including physical therapy, education, non-steroidal anti-inflammatories (NSAIDs), intra-articular injections, and activity modification. However, there is limited data supporting these claims as few studies have explored non-surgical management. Additionally, the authors were not able to find any studies on factors that portend outcomes of non-operative management. We hypothesized that patients with more significant bony FAI pathology or more severe osteoarthritis would have poorer outcomes.Methods:Eighty patients with acetabular labral tears, confirmed by MRI, receiving a minimum of one year of non-surgical management were identified. Subjects completed baseline patient reported outcome measures (PROMs: mHHS, HOS-ADL, HOS-SS, iHOT-33). Sixty five (81.25%) patients completed the same one-year follow-up functional outcomes measures in addition to a satisfaction questionnaire (37F, 28 M). Chart review was conducted to obtain demographic information and radiographic information (Tonnis grade, alpha angle, center edge angle, chondral damage, cartilage defects, cysts, and subchondral edema). Statistical significance (p<0.05) was determined t-test, anova, or Wilcoxon rank-sum.Results:Average follow up time was 24 months (R:18-30). The mean age was 41.7(R:18-57), average BMI was 26.2 (R18-39), and average Tonnis grade was 0.6 (R0-2). At follow-up, overall patients experienced a significant improvement in functional outcomes (mHHS: 66.6 vs 75.18, HOS-ADL: 75.7 vs 85.8, HOS-SS: 54 vs 69.7, iHOT-33: 47.9 vs 65.4). There was a positive correlation between baseline PROMs and follow-up PROMs as well as a negative correlation between baseline PROMs and change in PROMs over time. Tonnis grade, chondral damage, and cartilage defects portended significantly worse outcomes across all PROMs at follow-up. Presence of cysts or subchondral edema was also correlated with worse outcomes but these findings did not reach statistical significance. (Table 2). Alpha angle >55 (cam lesion) resulted in significantly worse outcomes across all PROMs although CEA>40 (pincer lesion) only reached significance for the HOS ADL and SSS. CEA< 25 (dysplasia) trended toward worse outcomes but did not reach significance. (Table1)Conclusion:Due to the limited healing potential of the labrum, the associated anatomical defects of FAI, and the potential for progression to osteoarthritis, there has been a focus on surgical intervention for FAI and labral tears. Despite a lack of evidence for its use, non-surgical management is frequently cited as the first step to treatment. As we found in a previous analysis, patients with symptomatic labral tears can experience functional improvement after minimum one year of non-surgical management. Those with signs of higher grade arthritis performed significantly worse that their less arthritic counterparts. Those with larger cam and pincer lesions also improved less than patients with less significant bony morphology. This study can help inform surgeons and their patients when they present with hip pain and inquire about non-surgical management.Change in patient reported outcome measures from baseline to follow-up for osseous morphologymHHSP ValueHOS-ADLP ValueHOS-SSSP ValueiHOT-33P value CEA<25 0.48140.07510.12140.3223No9.0 (14.8)11(19)17(30)18(25.4)Yes3.8(14.6)-5(13)-2(22)11.3(12.1) CEA>40 0.06840.01850.02160.0838No10(14.7)12(19)19(30)20(24)Yes0.9(13.2)1(12)-2(22)3.8(25.2) Alpha>55 0.00010.00790.0010.0001No12.1(14.1)13(19)21(29)25.1(20.6)Yes-4.0(9.0)-1(14)-4(20)-10.4(17.2)Change in patient reported outcome measures from baseline to follow-up for cartilage statusmHHSp valueHOS-ADLp valueHOS-SSSp valueiHOT-33p value Edema 0.09450.89950.83330.1312No10.2 (14.4)10 (20)16 (28)20.4 (21.9)Yes1.8 (14.7)10 (14)14 (37)4.6 (32.5) Cartilage Degeneration 0.00010.00010.00010.0001No18.0 (9.1)19(17)29(27)31.7(17.0)Yes-5.4(9.4)-3(12)-4(22)-4.0(17.9) Cartilage Defect 0.00010.00090.00890.0002No12.0(13.3)14(18)20(28)22.7(22.9)Yes-6.4 (11.2)-6 (11)-5 (26)-5.9 (18.4)

Indications for Hip Arthroscopy

Context:Hip arthroscopy is gaining popularity within the field of orthopaedic surgery. The development and innovation of hip-specific arthroscopic instrumentation and improved techniques has resulted in improved access to the hip joint and ability to treat various hip pathologies.Evidence Acquisition:Electronic databases, including PubMed and MEDLINE, were queried for articles relating to hip arthroscopy indications (1930-2017).Study Design:Clinical review.Level of Evidence:Level 4.Results:Initially used as a technique for loose body removal, drainage/debridement of septic arthritis, and treatment of pediatric hip disorders, hip arthroscopy is currently used to treat various hip conditions. The recognition of femoroacetabular impingement (FAI) as a source of hip pain in young adults has rapidly expanded hip arthroscopy by applying the principles of osseous correction that were previously described and demonstrated via an open surgical dislocation approach. Hip pathologies can be divided into central compartment, peripheral compartment, peritrochanteric space, and subgluteal space disorders.Conclusion:Although hip arthroscopy is a minimally invasive procedure that may offer decreased morbidity, diminished risk of neurovascular injury, and shorter recovery periods compared with traditional open exposures to the hip, it is important to understand the appropriate patient selection and indications.

Prevalence of FAI radiographic hip abnormalities in elite soccer players: are there differences related to skeletal maturity?

BackgroundFemoroacetabular impingement (FAI) can be a source of hip pain in young adults. Some reports have revealed that participation in high-impact sports may play a role in the development of...

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Subspine impingement has been increasingly recognized as a source of hip pain over the past 5 to 10 years. Some surgeons routinely perform subspine/anterior inferior iliac spine (AIIS) decompressions, whereas others rarely perform these procedures as part of an arthroscopic hip procedure. Subspine impingement has been implicated with high range-of-motion activities, various AIIS morphologies and deformities, and in the setting of persistent anterior hip pain after intra-articular anesthetic injections. Dynamic computed tomographic imaging has recently shown subspine impingement even with relatively normal AIIS morphology and in the setting of decreased femoral anteversion. These findings further emphasize the importance of understanding and defining relationships between morphology and impingement. Ultimately, subspine decompressions might be critical to achieve the best possible outcome after arthroscopic hip procedures in a subset of patients, but making the diagnosis remains challenging for clinicians.

Hip arthroscopy: State of the Art

Hip arthroscopy has become increasingly common worldwide as advances have been made in the understanding of the pathophysiology of hip injuries as well as technological advances in arthroscopic surgical techniques and instrumentation. In evaluating a patient with hip pain, it is important to obtain a detailed history and to perform a comprehensive physical examination, and then arrange appropriate radiographic and other special tests. Radiography, CT scan and MRI/MR arthrogram are frequently useful in diagnosing hip pathology, but are not all necessary. Intra-articular injection of an anaesthetic with or without steroid should be considered for diagnostic and potentially therapeutic purposes if intra-articular sources of hip pain are part of the differential diagnosis. Conditions which were previously treated with open surgery are now frequently managed with arthroscopic intervention, such as removal of loose bodies, chondral injury, labral injury, femoroacetabular impingement, snapping hip and gluteus medius tears. Complication rates of hip arthroscopy are relatively low (

Does treatment by a specialist physiotherapist change pain and function in young adults with symptoms from femoroacetabular impingement? A pilot project for a randomised controlled trial

AimFemoroacetabular impingement (FAI) is recognised as a source of hip pain but the effect of conservative treatment remains untested. This pilot study aimed to inform and evaluate the methods required to conduct a substantive trial comparing the effect of treatment by a physiotherapist versus routine care on the symptoms of FAI. DesignA parallel group, pilot randomised controlled trial (RCT). SettingA single NHS acute hospital trust, Devon, England. Participants30 adults with symptomatic FAI were recruited. 23 (77%) completed the study. InterventionsIntervention was 3 months of treatment by a specialist physiotherapist. The control group received routine care. Main outcomesChange in pain and function was measured using a Visual Analogue Scale, Non Arthritic Hip Score (NAHS), Lower Extremity Functional Score (LEFS) and Hip Outcome Score. ResultsParticipants in the intervention arm undertook a personalised exercise programme to improve pelvic and femoral control plus advice on posture, activity pacing and pain relief. The mean change in NAHS for the intervention group was 12.7 (95% CI 4.7 to 20.7) and 1.8 (95% CI −5.3 to 9.0) in the control group; Median change in LEFS was 11.5 (95% CI 5.0 to 26.0) versus −1.0 (95% CI −7.0 to 4.0). This improvement in LEFS was beyond minimal clinically important difference in the intervention group. Pain scores improved marginally in both groups. ConclusionsMethodological strengths and weaknesses were successfully identified for a substantive study. Further research is needed to evaluate the relative influence of structural and neuromuscular features on symptoms of FAI and the role of conservative treatment.

Atraumatic Hip Instability in Patients With Joint Hypermobility

Atraumatic hip instability is a recently described source of hip pain and disability. Hip instability may be caused by bony dysplasia, benign or inherited joint hypermobility syndromes, or iatrogenic damage to the hip capsule during arthroscopy. A thorough understanding of hip capsular anatomy is essential to the management of instability, and is reviewed in this study. In addition, the essential historical, clinical, and radiographic findings of atraumatic hip instability are presented. Critical concepts include early referral in the presence of inherited joint hypermobility syndromes, the use of validated criteria for detection of benign joint hypermobility, and systematic efforts to understand the cause of instability before initiating treatment. Although nonoperative measures can successfully treat atraumatic hip instability, surgical intervention is often warranted, and the technical principles of hip capsular plication are described in detail.

Surgical Hip Dislocation for Treatment of Femoroacetabular Impingement Which are the Red Lights for Poor Results

Background: Femoroacetabular impingement is a common source of hip pain and dysfunction, especially in young and active patients. It is considered to be the main cause of early hip osteoarthritis. We set the purpose to identify poor prognosis factors in the surgical treatment of femoroacetabular impingement. Methods: We realized a prospective observational study in a case series of 50 hips in 44 patients with femoroacetabular impingement operated with surgical hip dislocation between 2001 and 2006. Clinical, radiologic, surgical and functional factors of whole patients were assessed. Clinical outcomes were determined with a subjective scale. Also, functional assessment was performed with a modified Harris Hip Score (HHS). Both evaluations were applied at 6, 9, and 12 months, and so every year once. Finally, the statistical analysis was done with SPSS 15.0 software. Results: With an average of 6.2 post-operative years (5-10.1) of follow-up, 35 patients (70%) were “asymptomatic” (HHS=100), 11 patients (22%) “better” (HHS=94.09), and 4 patients (8%) “the same or worse” (HHS=68.25). 40% of patients older than 45 years old were “asymptomatic”, versus 77% younger than 45 years old (p=0.03). 37% of patients with mixed femoroacetabular impingement were “asymptomatic”, 87% of patients with cam-type and 82% with picer-type (p=0.003). The factors related to a poor prognosis were as follows: age >45 and mixed-type impingement; and other factors such as radiological osteoarthritis, labral injury and prolonged symptomatology were also associated to poor prognosis results in our study, without being statistically significant. Conclusion: Age > 45 years old and mixed type of impingement are significant statistic factors related to a poor prognosis in patients treated with surgical hip dislocation. This data are useful to predict the treatment outcome for each patient.

FRI0207 Prevalence of Femoroacetabular Impingement in Caucasians Compared to Chinese in Vancouver, Canada: A Population-Based Study

BackgroundFemoroacetabular Impingement (FAI) is one source of hip pain in young adults and has been suggested as a major cause of hip osteoarthritis (OA). The prevalence of radiographic hip OA...

Evaluation of Hip Pain in Young Adults

Hip pain is a common complaint in the young, athletic patient population. Primary, intra-articular sources of hip pain are becoming increasingly recognized by primary care providers and sports medicine specialists. Prior to deciding among the various treatment options for the many sources of hip pain in the athletic patient population, the clinician must be able to recognize and accurately diagnose the underlying pathology. Advances in imaging modalities and our understanding of the pathophysiology have improved our ability to accurately understand and diagnose the source of hip pain in this patient population. This review presents a comprehensive strategy for the workup and diagnosis of young, athletic patients presenting with hip pain, and provides the sports medicine specialist with the tools to correlate the patient's history, physical examination, and imaging findings and to treat these challenging patients.