scholarly journals Leg dominance as a risk factor for femoroacetabular impingement syndrome

Author(s):  
Lei Zhao ◽  
Peng Wang ◽  
Weixin Li
2020 ◽  
Vol 7 (1) ◽  
pp. 22-26
Author(s):  
Matthew T Philippi ◽  
Timothy L Kahn ◽  
Temitope F Adeyemi ◽  
Travis G Maak ◽  
Stephen K Aoki

Abstract One etiological factor of femoroacetabular impingement syndrome (FAIS) is high impact athletics involving deep hip flexion, axial loading and jumping during skeletal development. Previous work has established that there is physiologic asymmetry of the lower limbs regarding function, with the dominant limb being primarily responsible for propulsion and kicking while the non-dominant limb is responsible for stability and planting. The authors hypothesize that the dominant limb will be more likely to undergo hip arthroscopy for symptomatic FAIS. Four hundred and sixty-nine patients at a single surgical center who underwent primary or revision hip arthroscopy for cam-type FAIS were identified. Patients were asked to identify their dominant lower extremity, defined as the lower extremity preferred for kicking. Sixty patients who indicated bilateral leg dominance were excluded. It was assumed that with no association between limb dominance and the need for surgery, the dominant side would have surgery 50% of the time. Enrichment for surgery in the dominant limb was tested for using a one-sample test of proportions, determining whether the rate differed from 50%. The enrichment for surgery on the dominant side was 57% (95% confidence interval 52–62%) which was significantly different from the rate expected by chance (50%), P = 0.003. No other significant differences were noted between groups. Limb dominance appears to be an etiological factor in the development of cam-type FAIS. Patients are more likely to undergo arthroscopic treatment of FAIS on their dominant lower extremity, although the non-dominant lower extremity frequently develops FAIS as well.


2018 ◽  
Vol 2 (11) ◽  
pp. e070
Author(s):  
Natalie L. Leong ◽  
William Neal ◽  
Thomas Alter ◽  
Edward Beck ◽  
Shane J. Nho

Author(s):  
Guillaume D. Dumont ◽  
Matthew J. Pacana ◽  
Adam J. Money ◽  
Thomas J. Ergen ◽  
Allen J. Barnes ◽  
...  

AbstractFemoroacetabular impingement syndrome (FAIS) is commonly associated with acetabular labral tears. Correction of impingement morphology and suture anchor repair of labral tears have demonstrated successful early and midterm patient-reported outcomes. The purpose of this study was to evaluate the posterior and anterior extent and size of labral tears in patients with FAIS undergoing arthroscopic labral repair, and to evaluate the number of suture anchors required to repair these tears. The design of this study was retrospective case series (Level 4). A single surgeon's operative database was retrospectively reviewed to identify patients undergoing primary arthroscopic hip labral repair between November 2014 and September 2019. Patient-specific factors and radiographic measurements were recorded. Arthroscopic findings including labral tear posterior and anterior extents, and the number of suture anchors utilized for the repair were recorded. Linear regression was performed to identify factors associated with labral tear size. The number of suture anchors used relative to labral tear size was calculated. Three-hundred and thirteen patients were included in the study. The mean posterior and anterior extent for labral tears were 11:22 ± 52 and 2:20 ± 34 minutes, respectively. Mean tear size was 2 hours, 58 minutes ± 45 minutes. The mean number of suture anchors utilized for labral repair was 3.1 ± 0.7. The mean number of anchors per hour of labral tear was 1.1 ± 0.3. Increased age, lateral center edge angle, and α angle were associated with larger labral tears. Our study found that acetabular labral tears associated with FAIS are, on average, 3 hours in size and centered in the anterosuperior quadrant of the acetabulum. Arthroscopic labral repair required 1.1 anchors per hour of tear size, resulting in a mean of 3.1 anchors per repair. Level of Evidence IV


2021 ◽  
Vol 9 (10) ◽  
pp. 232596712110345
Author(s):  
Steven F. DeFroda ◽  
Thomas D. Alter ◽  
Blake M. Bodendorfer ◽  
Alexander C. Newhouse ◽  
Felipe S. Bessa ◽  
...  

Background: The influence of femoral torsion on clinically significant outcome improvement after hip arthroscopy for femoroacetabular impingement syndrome (FAIS) has not been well-studied. Purpose: To quantify femoral torsion in FAIS patients using magnetic resonance imaging (MRI) and explore the relationship between femoral torsion and clinically significant outcome improvement after hip arthroscopy. Study Design: Cohort study; Level of evidence, 3. Methods: Included were patients who underwent hip arthroscopy for FAIS between January 2012 and August 2018 and had 2-year follow-up and preoperative MRI scans containing transcondylar slices of the knee. Participants were categorized as having severe retrotorsion (SR; <0°), normal torsion (NT; 0°-25°), and severe antetorsion (SA; >25°) as measured on MRI. Patient-reported outcomes (PROs) included the Hip Outcome Score–Activities of Daily Living, Hip Outcome Score–Sports Subscale, modified Harris Hip Score, 12-item International Hip Outcome Tool (iHOT-12), and visual analog scale (VAS) for pain and satisfaction. Achievement of Patient Acceptable Symptom State (PASS) and substantial clinical benefit (SCB) were analyzed among cohorts. Results: Included were 183 patients (SR, n = 13; NT, n = 154; SA, n = 16) with a mean age, body mass index, and femoral torsion of 30.6 ± 12.1 years, 24.0 ± 4.4 kg/m2, and 12.55° ± 9.58°, respectively. The mean torsion was –4.5° ± 2.6° for the SR, 12.1° ± 6.8° for the NT, and 31.0° ± 3.6° for the SA group. There were between-group differences in the proportion of patients who achieved PASS and SCB on the iHOT-12, pain VAS, and any PRO ( P < .05). Post hoc analysis indicated that the SA group achieved lower rates of PASS and SCB on the iHOT-12 and pain VAS, and lower rates of PASS on any PRO versus the SR group ( P < .05); the SR group achieved higher rates of PASS and SCB on pain VAS scores versus the NT group ( P = .003). Conclusion: The orientation and severity of femoral torsion during hip arthroscopy influenced the propensity for clinically significant outcome improvement. Specifically, patients with femoral retrotorsion and femoral antetorsion had higher and lower rates of clinically significant outcome improvement, respectively.


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