scholarly journals Hip morphology in elite golfers: asymmetry between lead and trail hips

2016 ◽  
Vol 50 (17) ◽  
pp. 1081-1086 ◽  
Author(s):  
Edward Dickenson ◽  
Philip O'Connor ◽  
Philip Robinson ◽  
Robert Campbell ◽  
Imran Ahmed ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Hip Morphology ◽  
Labral Tears ◽  
Articular Pathology ◽  
Α Angle ◽  
First Time ◽  
Cam Morphology ◽  
Pincer Morphology ◽  
Side Asymmetry ◽  
Head Neck

AimDuring a golf swing, the lead hip (left hip in a right-handed player) rotates rapidly from external to internal rotation, while the opposite occurs in the trail hip. This study assessed the morphology and pathology of golfers’ hips comparing lead and trail hips.MethodsA cohort of elite golfers were invited to undergo MRI of their hips. Hip morphology was evaluated by measuring acetabular depth (pincer shape=negative measure), femoral neck antetorsion (retrotorsion=negative measure) and α angles (cam morphology defined as α angle >55° anteriorly) around the axis of the femoral neck. Consultant musculoskeletal radiologists determined the presence of intra-articular pathology.Results55 players (mean age 28 years, 52 left hip lead) underwent MRI. No player had pincer morphology, 2 (3.6%) had femoral retrotorsion and 9 (16%) had cam morphology. 7 trail hips and 2 lead hips had cam morphology (p=0.026). Lead hip femoral neck antetorsion was 16.7° compared with 13.0° in the trail hip (p<0.001). The α angles around the femoral neck were significantly lower in the lead compared with trail hips (p<0.001), with the greatest difference noted in the anterosuperior portion of the head neck junction; 53° vs 58° (p<0.001) and 43° vs 47° (p<0.001). 37% of trail and 16% of lead hips (p=0.038) had labral tears.ConclusionsGolfers’ lead and trail hips have different morphology. This is the first time side-to-side asymmetry of cam prevalence has been reported. The trail hip exhibited a higher prevalence of labral tears.

scholarly journals Arthroscopic management of an intraarticular osteochondroma of the hip

2009 ◽  
Vol 1 (1) ◽  
pp. 2 ◽  
Author(s):  
Brian T. Feeley ◽  
Bryan T. Kelley
Keyword(s):  
Case Report ◽  
Femoral Head ◽  
Femoral Neck ◽  
Hip Arthroscopy ◽  
Arthroscopic Management ◽  
Surgical Dislocation ◽  
Labral Tears ◽  
Articular Pathology ◽  
Dislocation Of The Hip

The role of hip arthroscopy in the management of femoroacetabular impingement (FAI) has been advancing rapidly. In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman. Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intra articular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip musculature, is useful in treatment of labral tears generated by FAI, and can be used to resect small lesions on the femoral head.

scholarly journals Revision Hip Arthroscopy in the Native Hip: A Review of Contemporary Evaluation and Treatment Options

2021 ◽  
Vol 8 ◽  
Author(s):  
Kyle N. Kunze ◽  
Reena J. Olsen ◽  
Spencer W. Sullivan ◽  
Benedict U. Nwachukwu
Keyword(s):  
Hip Arthroscopy ◽  
Treatment Options ◽  
Labral Repair ◽  
Residual Symptoms ◽  
Femoroacetabular Impingement Syndrome ◽  
Comprehensive Examination ◽  
Cam Morphology ◽  
Pincer Morphology ◽  
Head Neck ◽  
Symptom Recurrence

Hip arthroscopy is a reproducible and efficacious procedure for the treatment of femoroacetabular impingement syndrome (FAIS). Despite this efficacy, clinical failures are observed, clinical entities are challenging to treat, and revision hip arthroscopy may be required. The most common cause of symptom recurrence after a hip arthroscopy that leads to a revision arthroscopy is residual cam morphology as a result of inadequate femoral osteochondroplasty and restoration of head–neck offset, though several other revision etiologies including progressive chondral and labral pathologies also exist. In these cases, it is imperative to perform a comprehensive examination to identify the cause of a failed primary arthroscopy as to assess whether or not a revision hip arthroscopy procedure is indicated. When a secondary procedure is indicated, approaches may consist of revision labral repair, complete labral reconstruction, or labral augmentation depending on labral integrity. Gross instability or imaging-based evidence of microinstability may necessitate capsular augmentation or plication. If residual cam or pincer morphology is present, additional resection of the osseous abnormalities may be warranted. This review article discusses indications, the evaluation of patients with residual symptoms after primary hip arthroscopy, and the evaluation of outcomes following revision hip arthroscopy through an evidence-based discussion. We also present a case example of a revision hip arthroscopy procedure to highlight necessary intraoperative techniques during a revision hip arthroscopy.

scholarly journals Hip pain and its correlation with cam morphology in young skiers—a minimum of 5 years follow-up

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Josefin Abrahamson ◽  
Pall Jónasson ◽  
Mikael Sansone ◽  
Anna Swärd Aminoff ◽  
Carl Todd ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Hip Pain ◽  
Activity Level ◽  
Conflicting Evidence ◽  
Magnetic Resonance Imaging Mri ◽  
The Right ◽  
Α Angle ◽  
Cam Morphology ◽  
Elite Skiers

Abstract Background There is conflicting evidence regarding the association between cam morphological changes and hip pain, and it remains unclear who with cam morphology will develop hip pain and who will not. This study aimed to investigate the correlation between cam morphology, hip pain, and activity level at a 5-year follow-up in young Alpine and Mogul skiers. Method All students (n = 76) at Åre Ski National Sports High School were invited and accepted participation in this prospective study at baseline. Magnetic resonance imaging (MRI) of both hips was conducted to evaluate the presence of cam morphology (α-angle ≥ 55°) and its size alongside the reporting of hip pain, type, and frequency of training by the Back and hip questionnaire, at baseline. After 5 years, the skiers were invited to complete a shortened version of the same questionnaire. Results A total of 60 skiers (80%) completed the follow-up questionnaire, of which 53 had concomitant MRI data. Cam morphology was present in 25 skiers (47.2%, 39 hips). Hip pain at baseline and at follow-up was reported in 17 (28.3%) and 22 (36.7%) skiers, respectively. No correlations were found between the activity level, the frequency, and the size of cam morphology and hip pain, except for the right hip α-angle at 1 o’clock and hip pain in skiers with cam morphology at baseline (rs = 0.49; P = 0.03) and at follow-up (rs = 0.47; P = 0.04). A total of 73.3% skiers had retired, of which 48% reported this was due to injuries. Conclusion Hip pain was not shown to be correlated, or had a low correlation, with activity level and the presence and size of cam morphology in young skiers on a 5-year follow-up. Based on these results, cam morphology or activity level did not affect hip pain to develop during 5 years of follow-up in young skiers. Furthermore, this study highlights that almost 75% of young elite skiers had retired from their elite career with almost 50% reporting that this was due to injuries sustained from skiing.

scholarly journals Fully automated image-based estimation of postural point-features in children with cerebral palsy using deep learning

2019 ◽  
Vol 6 (11) ◽  
pp. 191011 ◽  
Author(s):  
Ryan Cunningham ◽  
María B. Sánchez ◽  
Penelope B. Butler ◽  
Matthew J. Southgate ◽  
Ian D. Loram
Keyword(s):  
Cerebral Palsy ◽  
Linear Interpolation ◽  
Clinical Test ◽  
Test Results ◽  
Automated Identification ◽  
Trunk Control ◽  
Children With Cerebral Palsy ◽  
First Time ◽  
Testing Linear ◽  
Head Neck

The aim of this study was to provide automated identification of postural point-features required to estimate the location and orientation of the head, multi-segmented trunk and arms from videos of the clinical test ‘Segmental Assessment of Trunk Control’ (SATCo). Three expert operators manually annotated 13 point-features in every fourth image of 177 short (5–10 s) videos (25 Hz) of 12 children with cerebral palsy (aged: 4.52 ± 2.4 years), participating in SATCo testing. Linear interpolation for the remaining images resulted in 30 825 annotated images. Convolutional neural networks were trained with cross-validation, giving held-out test results for all children. The point-features were estimated with error 4.4 ± 3.8 pixels at approximately 100 images per second. Truncal segment angles (head, neck and six thoraco-lumbar–pelvic segments) were estimated with error 6.4 ± 2.8°, allowing accurate classification ( F 1 > 80%) of deviation from a reference posture at thresholds up to 3°, 3° and 2°, respectively. Contact between arm point-features (elbow and wrist) and supporting surface was classified at F 1 = 80.5%. This study demonstrates, for the first time, technical feasibility to automate the identification of (i) a sitting segmental posture including individual trunk segments, (ii) changes away from that posture, and (iii) support from the upper limb, required for the clinical SATCo.

Sex Differences of Hip Morphology in Young Adults With Hip Pain and Labral Tears

2013 ◽  
Vol 29 (1) ◽  
pp. 54-63 ◽  
Author(s):  
Iftach Hetsroni ◽  
Katrina Dela Torre ◽  
Gavin Duke ◽  
Stephen Lyman ◽  
Bryan T. Kelly
Keyword(s):  
Young Adults ◽  
Sex Differences ◽  
Hip Pain ◽  
Hip Morphology ◽  
Labral Tears

scholarly journals Professional golfers’ hips: prevalence and predictors of hip pain with clinical and MR examinations

2016 ◽  
Vol 50 (17) ◽  
pp. 1087-1091 ◽  
Author(s):  
Edward Dickenson ◽  
Imran Ahmed ◽  
Miguel Fernandez ◽  
Philip O'Connor ◽  
Philip Robinson ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hip Pain ◽  
Hip Morphology ◽  
Hip Range Of Motion ◽  
Related Quality ◽  
Professional Golfers ◽  
Labral Pathology ◽  
Outcome Tool ◽  
Α Angle

AimsThis study aimed to determine the prevalence of hip pain in professional golfers, comparing the lead (left hip in right-handed golfer) and trail hips, and to establish what player characteristics predicted hip symptoms.MethodsMale elite professional golf players were invited to complete questionnaires and undergo clinical and MR examinations while attending the Scottish Hydro Challenge 2015. Questionnaires determined player demographics, self-reported hip pain and an International Hip Outcome Tool 12 (iHOT12) score (hip-related quality of life). Clinical examinations determined hip range of motion and the presence of a positive impingement test. MR scans determined the presence of labral pathology and player hip morphology with measures of α angle (cam), acetabular depth (pincer) and femoral neck antetorsion.ResultsA total of 109 (70% of tournament field) of players completed questionnaires, 73 (47%) underwent clinical examination and 55 (35%) underwent MR examination. 19.3% of players reported of hip pain. 11.9% of lead and 9.1% of trail hips were painful (p=0.378), iHOT12 scores were lower in the lead (94.1) compared to the trail hip (95.3) (p=0.007). Stepwise multiple linear regression modelling was able to predict 20.7% of the variance in iHOT12 scores with mean α angles between 12 and 3 o'clock, and increasing age-significant variables (R2=0.207, p<0.001; β=−0.502, p<0.001 and β=−0.399, p=0.031, respectively).Conclusions19.3% of male professional golfers reported hip pain. The presence of an increasing α angle and increasing age were significant predictors of reduced hip-related quality of life.

scholarly journals Letter to Editor - A Clinical ‘PIC- Perspectives, issues & Concerns” on Idiopathic Transient Osteoporosis during Pregnancy with alarm bells on its Idiopathic nature - Response

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Sharat Agarwal
Keyword(s):  
Bone Marrow ◽  
Bone Marrow Edema ◽  
Transient Osteoporosis ◽  
Bone Marrow Edema Syndrome ◽  
Labral Tears ◽  
Transient Bone Marrow Edema ◽  
Bone Marrow Edema Pattern ◽  
Magnetic Resonance Imaging Mri ◽  
Articular Pathology ◽  
Marrow Edema

Dear Editor, At the outset, I would like to congratulate the authors of the article published in your journal in the current issue entitled- Idiopathic Transient Osteoporosis during Pregnancy – Report of a Clinical Case JOCR November – December 2019 Volume 9 Issue 6 Page 54-57. However, I regret to mention that the workup mentioned in this article needs to be improved, before one can come to definitive diagnosis of Idiopathic Transient Osteoporosis during Pregnancy. I would like to highlight various perspectives, issues & concerns, the knowledge of which are must for the readers of this journal pertaining to this disorder. It is pertinent to mention no doubt the increasing utilization of magnetic resonance imaging (MRI) has allowed physicians to investigate edematous changes in bone marrow, a clinically important entity which was previously undetected on conventional radiographs. The first use of the term “bone marrow edema” was by Wilson et al in 1988, and the term “bone marrow edema syndrome” was described in 1993 after the investigation of histological specimens [1]. Later on, importantly Hayes et al. advocated that the term “transient bone marrow edema syndrome” should be used for patients in whom the bone marrow edema pattern was not accompanied by radiographic evidence of osteopenia [2]. And thus separating the two entities i.e. “the transient bone marrow edema syndrome” and “Transient Osteoporosis” Occurrence of hip pain during pregnancy is quite common, although transient osteoporosis as a condition causing this symptom is uncommonly seen. Clinicians should also be aware of intra-articular disorders such as loose bodies, and labral tears; peri-articular pathology such as tendinitis and bursitis; or extra-articular conditions such as referred pain from the lumbar spine, the sacroiliac joint, and or from nerve entrapment syndromes. So, a detailed history and physical examination is helpful to narrow the differential diagnoses, which, in turn, dictate the modal

scholarly journals Pattern of Inflammatory Molecules in Cartilage of the Impingement Zone in FAI Hips Suggests Origin of Hip Degeneration

2019 ◽  
Vol 7 (7_suppl5) ◽  
pp. 2325967119S0032
Author(s):  
Cecilia Pascual-Garrido ◽  
Masahiko Haneda ◽  
Muhammad Farooq Rai ◽  
Robert H. Brophy ◽  
John C. Clohisy
Keyword(s):  
Cartilage Damage ◽  
Hip Osteoarthritis ◽  
Developmental Dysplasia ◽  
Mankin Score ◽  
Junction Area ◽  
Hip Impingement ◽  
Α Angle ◽  
Inflammatory Molecules ◽  
Head Neck ◽  
Neck Junction

Objectives: Femoroacetabular impingement (FAI) is considered a common cause of articular cartilage damage and early hip osteoarthritis (OA) in the young-adult patients. Molecular inflammation is believed to be one of the main initiators of hip OA. Matrix metalloproteinase (MMP)-13 and a disintegrin and metalloproteinase with thrombospondin motifs (ADAMTS)-4 are known to function as extracellular matrix degrading enzymes in OA joints and have been shown to increase during the process of OA onset. Interleukin (IL)-1β is considered one of the key cytokines involved in the pathogenesis of OA. The aim of this study is to characterize inflammation and early OA pathways in cartilage from the head-neck impingement area in patients with symptomatic FAI cam. Methods: Cartilage samples were obtained in the head neck-junction area from 37 patients undergoing hip surgery between May 2017 and July 2018. Nine patients had a clinical diagnosis of FAI cam (FAI cam) and 15 patients presented advanced OA secondary to FAI cam (OA FAI). These cartilage samples were compared to cartilage samples obtained from similar head neck-junction area from 13 patients with advanced OA secondary to developmental dysplasia of the hip with no impingement (OA DDH). Radiographically, the α-angle was utilized to confirm hip impingement. All histological sections were stained with Safranin-O to assess cartilage degeneration. OARSI grade and Mankin score were used to quantify degenerative OA changes. Immunohistochemistry was performed for IL-1β, MMP-13 and ADAMTS-4. Quantification of immunopositive cells was performed in a blinded fashion. One-way analysis of variance with Tukey’s post hoc test was applied to analyze differences between three groups. Results: FAI cam patients were significantly younger than OA FAI patients (p<0.001) and OA DDH patients (p=0.0461) (Table 1). The average α-angle was significantly higher in the FAI cam and OA FAI groups than the OA DDH group (p<0.001). Cartilage samples from the FAI cam and the OA FAI groups showed degenerative changes. The average OARSI grade was significantly (p<0.01) higher in FAI cam (4.0±0.4) and OA FAI (3.6±0.9) compared to OA DDH (2.2±0.6). The average Mankin score was significantly (p<0.001) higher in FAI cam (7.6±1.2) and OA FAI (6.9±1.8) than OA DDH (4.1±0.7). IL-1β was expressed in cartilage samples from all groups, although the pattern varied.IL-1β was expressed mainly in the superficial layer in the OA DDH group but throughout all cartilage layers in the FAI cam and OA FAI groups. The % immunopositive cells were significantly (p<0.001) higher in FAI cam (58.1±8.9) and OA FAI (71.3±12.4) than OA DDH (28.9±6.3). Similar pattern of distribution was observed for MMP-13 (72.7±11.3, 70.2±18.2 vs 38.0±8.6; p<0.001, p<0.001) and ADAMTS-4 (73.1±7.3, 82.0±12.3 vs 45.3±12.7; p<0.001, p<0.001) (Figure 1). Conclusion: Osteoarthritic changes are evident in the cartilage from the head-neck area of patients with FAI cam morphology. Inflammatory molecules were evident in both early and late stages of hip impingement, suggesting the head-neck impingement area is a potential mediator of inflammation and joint degeneration. [Figure: see text][Table: see text]

scholarly journals The prevalence of femoroacetabular impingement anatomy in Division 1 aquatic athletes who tread water

2020 ◽  
Vol 7 (2) ◽  
pp. 233-241
Author(s):  
Joanna L Langner ◽  
Marianne S Black ◽  
James W MacKay ◽  
Kimberly E Hall ◽  
Marc R Safran ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Young Patients ◽  
Hip Pain ◽  
Water Polo ◽  
Increased Risk ◽  
Division 1 ◽  
Mri Scans ◽  
Asymptomatic Individuals ◽  
Cam Morphology ◽  
Pincer Morphology

Abstract Femoroacetabular impingement (FAI) is a disorder that causes hip pain and disability in young patients, particularly athletes. Increased stress on the hip during development has been associated with increased risk of cam morphology. The specific forces involved are unclear, but may be due to continued rotational motion, like the eggbeater kick. The goal of this prospective cohort study was to use magnetic resonance imaging (MRI) to identify the prevalence of FAI anatomy in athletes who tread water and compare it to the literature on other sports. With university IRB approval, 20 Division 1 water polo players and synchronized swimmers (15 female, 5 male), ages 18–23 years (mean age 20.7 ± 1.4), completed the 33-item International Hip Outcome Tool and underwent non-contrast MRI scans of both hips using a 3 Tesla scanner. Recruitment was based on sport, with both symptomatic and asymptomatic individuals included. Cam and pincer morphology were identified. The Wilcoxon Signed-Rank/Rank Sum tests were used to assess outcomes. Seventy per cent (14/20) of subjects reported pain in their hips yet only 15% (3/20) sought clinical evaluation. Cam morphology was present in 67.5% (27/40) of hips, while 22.5% (9/40) demonstrated pincer morphology. The prevalence of cam morphology in water polo players and synchronized swimmers is greater than that reported for the general population and at a similar level as some other sports. From a clinical perspective, acknowledgment of the high prevalence of cam morphology in water polo players and synchronized swimmers should be considered when these athletes present with hip pain.

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