Anatomic Predictors of Sagittal Hip and Pelvic Motions in Patients With a Cam Deformity

2018 ◽  
Vol 46 (6) ◽  
pp. 1331-1342 ◽  
Author(s):  
K.C. Geoffrey Ng ◽  
Mario Lamontagne ◽  
Jonathan R.T. Jeffers ◽  
George Grammatopoulos ◽  
Paul E. Beaulé
Keyword(s):  
Femoral Neck ◽  
Pelvic Incidence ◽  
Alpha Angle ◽  
Clinical Signs ◽  
Sacral Slope ◽  
Imaging Data ◽  
Training Strategy ◽  
Neck Shaft Angle ◽  
Cam Deformity ◽  
And Control

Background: As there is a high prevalence of patients with cam deformities and no ongoing hip dysfunction, understanding the biomechanical factors predicting the onset of symptoms and degenerative changes is critical. One such variable is how the spinopelvic parameters may influence hip and pelvic sagittal mobility. Hypothesis/Purpose: Pelvic incidence may predict sagittal hip and pelvic motions during walking and squatting. The purpose was to determine which anatomic characteristics were associated with symptoms and how they influenced functional hip and pelvic ranges of motion (ROMs) during walking and squatting. Study Design: Controlled laboratory study. Methods: Fifty-seven participants underwent computed tomography and were designated either symptomatic (n = 19, cam deformity with pain), asymptomatic (n = 19, cam deformity with no pain), or control (n = 19, no cam deformity or pain). Multiple femoral (cam deformity, neck angle, torsion), acetabular (version, coverage), and spinopelvic (pelvic tilt, sacral slope, pelvic incidence) parameters were measured from each participant’s imaging data, and sagittal hip and pelvic ROMs during walking and squatting were recorded using a motion capture system. Results: Symptomatic participants had large cam deformities, smaller femoral neck-shaft angles, and larger pelvic incidence angles compared with the asymptomatic and control participants. Discriminant function analyses confirmed that radial 1:30 alpha angle (λ1 = 0.386), femoral neck-shaft angle (λ2 = 0.262), and pelvic incidence (λ3 = 0.213) ( P < .001) were the best anatomic parameters to classify participants with their groups. Entering these 3 parameters into a hierarchical linear regression, significant regressions were achieved for hip ROM only when pelvic incidence was included for walking ( R2 = 0.20, P = .01) and squatting ( R2 = 0.14, P = .04). A higher pelvic incidence decreased walking hip ROM ( r = −0.402, P = .004). Although symptomatic participants indicated a trend of reduced squatting hip and pelvic ROMs, there were no significant regressions with the anatomic parameters. Conclusion: A cam deformity alone may not indicate early clinical signs or decreased ROM. Not only was pelvic incidence a significant parameter to classify the participants, but it was also an important parameter to predict functional ROM. Symptomatic patients with a higher pelvic incidence may experience limited sagittal hip mobility. Clinical Relevance: Patients with symptomatic femoroacetabular impingement showed a higher pelvic incidence and, combined with a cam deformity and varus neck, can perhaps alter the musculature of their iliopsoas, contributing to a reduced sagittal ROM. With an early and accurate clinical diagnosis, athletes could benefit from a muscle training strategy to protect their hips.

Morphometric study of proximal femur in fractured and non-fractured post menopausal women

2017 ◽  
Vol 10 (4) ◽  
pp. 313
Author(s):  
Lopamudra Nayak ◽  
Susmita Senapati ◽  
Sitanshu Kumar Panda ◽  
Prafulla Kumar Chinara
Keyword(s):  
Femoral Neck ◽  
Proximal Femur ◽  
Morphometric Study ◽  
Control Group ◽  
Head Width ◽  
Femoral Neck Axis ◽  
Neck Shaft Angle ◽  
The Mean ◽  
Axis Length ◽  
And Control

Objective: This study was conducted to investigate the risk of hip fracture using proximal femoral morphometry in fractured and nonfractured postmenopausal women.Methods: We conducted an observational cross-sectional study with 138 postmenopausal women (49 fractured and 89 nonfractured). The hip axis length (HAL), femoral neck axis length (FNAL), acetabular width (AW), femoral head width (FHW), femoral shaft width (FSW), and femoral neck shaft angle (FNSA) were measured in all cases by dual energy X-ray absorptiometry. We also studied the correlation between body mass index (BMI) with all the parameters in fractured and control groups.Results: The mean age, height, weight, and BMI were 61.24±3.23, 163.94±7.84 cm, 71.88±9.14 kg, and 26.72±2.78 kg/m², respectively, in fractured patients. In nonfractured patients the values were 59.73±5.32, 161.73±4.25 cm, 69.54±6.25 kg, and 26.74±2.23 kg/m² respectively. The mean HAL, FNAL, AW, FHW, FSW, and FNSA were 130.5±3.18 mm, 111.26±3.64 mm, 18.2±1.91 mm, 53.46±1.51 mm, 37.45±1.82 mm, and 132.76±3.15 degree incase group and 130.84±4.74 mm, 112.48±4.08 mm, 17.57±2.32 mm, 53.4±1.86 mm, 35.29±1.82 mm, and 128.76±3.6° in control group, respectively.Conclusion: The femoral parameters such as HAL, FNAL, AW, and FHW do not indicate any correlation between fractured and control groups, whereas FSW and FNSA were significantly higher in case group. The FNSA was having significant negative correlation with BMI in fractured group while that was having a significant positive correlation in the nonfractured group. This observation will be helpful in exploration of its clinical significance in proximal femoral fracture.Keywords: Proximal femur, Morphometry, Postmenopausal, Fracture.

scholarly journals Characteristics of hip impingement syndrome in patients with multiple hereditary exostoses

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yeong-Seub Ahn ◽  
Sungmin Kim ◽  
Woo-Jong Kim ◽  
Jun-Hyuk Lim ◽  
Sung-Taek Jung
Keyword(s):  
Femoral Neck ◽  
Alpha Angle ◽  
Hip Joints ◽  
Neck Shaft Angle ◽  
Multiple Hereditary Exostoses ◽  
Hip Impingement ◽  
Morphometric Measure ◽  
Shaft Angle ◽  
Coxa Valga ◽  
Symptom Group

Abstract Backgrounds This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome. Materials and methods Between 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp’s acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study. Results On hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp’s angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp’s angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4). Conclusion The results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms. Level of evidence Level III.

scholarly journals Increased Hip Stresses Resulting From a Cam Deformity and Decreased Femoral Neck-Shaft Angle During Level Walking

2016 ◽  
Vol 475 (4) ◽  
pp. 998-1008 ◽  
Author(s):  
K. C. Geoffrey Ng ◽  
Giulia Mantovani ◽  
Mario Lamontagne ◽  
Michel R. Labrosse ◽  
Paul E. Beaulé
Keyword(s):  
Femoral Neck ◽  
Neck Shaft Angle ◽  
Cam Deformity ◽  
Level Walking ◽  
Shaft Angle

scholarly journals The hip asphericity angle: a novel angle for measurement of Cam-FAI correction

2020 ◽  
Author(s):  
Mohammad Masoud ◽  
Adinun Apivatgaroon ◽  
Hatem Said ◽  
Mohamed M Abdel-Hamid ◽  
Maher El-Assal ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Alpha Angle ◽  
Quantitative Description ◽  
Control Group ◽  
Femoral Neck Axis ◽  
Reference Axis ◽  
Cam Deformity ◽  
Angle Correction ◽  
Systemic Error ◽  
Offset Correction

Abstract The alpha angle is routinely used for the diagnosis and quantitative description of the Cam deformity of the hip. However, a reliable identification of the femoral neck axis as its reference line can be difficult. Moreover, most cam resections include a reduction of the femoral neck diameter with an automatic posteromedial angulation of the femoral neck axis. In consequence, the reference axes for the pre- and postoperative alpha angles are different, and a comparison of both angles underlies a systematic error to relatively higher postoperative alpha angles. In order to avoid this systemic error, we propose the hip asphericity (HA) angle with a reference axis independent of the amount of bony resection. Two retrospective groups were formed, a ‘femoroacetabular impingement (FAI) group’ that had hip arthroscopy for cam resection and a ‘Control group’ without cam deformity. The alpha and HA angles were measured by three examiners. The measurements were repeated 1 month later. In the FAI group, offset correction was calculated using both angles. Statistically significant differences for both the alpha and the HA angles were found between the control and the preoperative FAI group as well as between the preoperative and postoperative FAI groups. The HA angle-correction by a mean of 27.5° was significantly higher in comparison to the alpha angle correction by a mean of 25.4°. The intertester and intratester reliability of both angles were not significantly different. The HA angle is a new and reliable radiographic parameter for measuring cam deformity and proves superior in measuring cam correction.

THE 2019 NOVEL PANDEMIC OF CORONAVIRUS DISEASE (COVID-19): A STUDY OF EXISTING EVIDENCE IN THE INDIAN POPULATION

2020 ◽  
Vol 7 (2) ◽  
pp. 199-204
Author(s):  
Shrikant Verma ◽  
Mohammad Abbas ◽  
Sushma Verma ◽  
Syed Tasleem Raza ◽  
Farzana Mahdi
Keyword(s):  
Disease Transmission ◽  
Indian Population ◽  
Respiratory Infections ◽  
Clinical Signs ◽  
Case Fatality ◽  
Public Health Emergency ◽  
The World ◽  
And Control ◽  
General Wellbeing ◽  
Different Parts

A novel spillover coronavirus (nCoV), with its epicenter in Wuhan, China's People's Republic, has emerged as an international public health emergency. This began as an outbreak in December 2019, and till November eighth, 2020, there have been 8.5 million affirmed instances of novel Covid disease2019 (COVID-19) in India, with 1,26,611 deaths, resulting in an overall case fatality rate of 1.48 percent. Coronavirus clinical signs are fundamentally the same as those of other respiratory infections. In different parts of the world, the quantity of research center affirmed cases and related passings are rising consistently. The COVID- 19 is an arising pandemic-responsible viral infection. Coronavirus has influenced huge parts of the total populace, which has prompted a global general wellbeing crisis, setting all health associations on high attentive. This review sums up the overall landmass, virology, pathogenesis, the study of disease transmission, clinical introduction, determination, treatment, and control of COVID-19 with the reference to India.

scholarly journals Poult Enteritis and Mortality Syndrome in Turkey Poults: Causes, Diagnosis and Preventive Measures

Animals ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 2063
Author(s):  
Awad A. Shehata ◽  
Shereen Basiouni ◽  
Reinhard Sting ◽  
Valerij Akimkin ◽  
Marc Hoferer ◽  
...  
Keyword(s):  
Preventive Measures ◽  
Clinical Signs ◽  
Accurate Diagnosis ◽  
Economic Losses ◽  
Turkey Poults ◽  
Causative Agents ◽  
Enteric Disorders ◽  
And Control ◽  
Enteropathogenic Viruses ◽  
Poult Enteritis

Poult enteritis and mortality syndrome (PEMS) is one of the most significant problem affecting turkeys and continues to cause severe economic losses worldwide. Although the specific causes of PEMS remains unknown, this syndrome might involve an interaction between several causative agents such as enteropathogenic viruses (coronaviruses, rotavirus, astroviruses and adenoviruses) and bacteria and protozoa. Non-infectious causes such as feed and management are also interconnected factors. However, it is difficult to determine the specific cause of enteric disorders under field conditions. Additionally, similarities of clinical signs and lesions hamper the accurate diagnosis. The purpose of the present review is to discuss in detail the main viral possible causative agents of PEMS and challenges in diagnosis and control.

The association between femoral neck shaft angle and degenerative disease of the hip in a cadaveric model

2021 ◽  
pp. 112070002110130
Author(s):  
Leigh-Anne Tu ◽  
Douglas S Weinberg ◽  
Raymond W Liu
Keyword(s):  
Femoral Head ◽  
Femoral Neck ◽  
Hip Osteoarthritis ◽  
Volume Ratio ◽  
Femoral Head Coverage ◽  
Neck Shaft Angle ◽  
Hip Arthritis ◽  
Femoral Version ◽  
Shaft Angle ◽  
The Impact

Background: While the influences of acetabular dysplasia and overcoverage on hip arthritis have been studied, the impact of femoral neck-shaft angle on hip arthritis is much more poorly understood. The purpose of this study is to determine if a relationship exists between neck shaft angle and the development of osteoarthritis, a better understanding of which would be useful to surgeons planning osteotomies about the hip. Methods: 533 cadaveric femora and acetabulae (1066 total) from the Hamann-Todd Osteological Collection (Cleveland, OH) were acquired. We measured true neck shaft angle using an AP photograph with the femoral neck parallel to the table. Femoral head volume to acetabular volume ratio, representing femoral head coverage, as well as femoral version were utilised. Correlation between neck shaft angle, femoral version, femoral head coverage and osteoarthritis were evaluated with multiple regression analysis. Results: The mean age and standard deviation was 56 ± 10 years. There were 64 females (12%) and 469 males. There were 380 Caucasians (71%) and 153 African-Americans. Mean femoral version was 11° ± 12° and mean true neck shaft angle was 127.7° ± 5.9° There was a strong correlation between age and arthritis (standardised beta 0.488, p < 0.001). There was a significant correlation between increasing true neck shaft angle and decreasing hip arthritis (standardised beta -0.024, p = 0.038). In the femoral head overcoverage subset, increasing true neck shaft angle was still significantly associated with decreasing hip arthritis (standardised beta −0.088, p = 0.018), although this relationship was not significant with femoral head undercoverage subset. Conclusions: With sufficient acetabular coverage, a relative increase in femoral neck shaft angle within the physiologic range is associated with decreased hip osteoarthritis. Clinical relevance: An understanding of the relationship between femoral neck shaft angle and hip osteoarthritis could be useful for surgeons planning pelvic or proximal femur osteotomies in children.

scholarly journals Characteristics of the spinopelvic parameters of patients with sacroiliac joint pain

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Juichi Tonosu ◽  
Hiroyuki Oka ◽  
Kenichi Watanabe ◽  
Hiroaki Abe ◽  
Akiro Higashikawa ◽  
...  
Keyword(s):  
Sacroiliac Joint ◽  
Joint Pain ◽  
Pelvic Incidence ◽  
Demographic Characteristics ◽  
Sacral Slope ◽  
Low Back ◽  
Spinopelvic Parameters ◽  
Sacroiliac Joint Pain ◽  
Physical Findings ◽  
Univariate Analyses

AbstractTo evaluate the characteristics of the spinopelvic parameters on radiography in patients with sacroiliac joint pain (SIJP). Two hundred fifty patients were included and divided into the SIJP group (those diagnosed with SIJP based on physical findings and response to analgesic periarticular injections; n = 53) and the non-SIJP group (those with low back pain [LBP] because of other reasons; n = 197). We compared their demographic characteristics and spinopelvic parameters using radiography. All differences found in the patients’ demographic characteristics and spinopelvic parameters were analyzed. More female participants experienced SIJP than male participants (P = 0.0179). Univariate analyses revealed significant differences in pelvic incidence (PI) (P = 0.0122), sacral slope (SS) (P = 0.0034), and lumbar lordosis (LL) (P = 0.0078) between the groups. The detection powers for PI, SS, and LL were 0.71, 0.84, and 0.66, respectively. Logistic regression analyses, after adjustment for age and sex, revealed significant differences in PI (P = 0.0308) and SS (P = 0.0153) between the groups, with odds ratios of 1.03 and 1.05, respectively. More female participants experienced SIJP than male participants. Higher PI and SS values were related to SIJP among LBP patients.

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