scholarly journals IDENTIFICATION OF FACTORS ASSOCIATED WITH DISEASE PROGRESSION IN THE CONTRALATERAL HIP OF PATIENTS WITH SYMPTOMATIC FEMOROACETABULAR IMPINGEMENT

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0014
Author(s):  
Adam Khan ◽  
Craig R. Louer ◽  
Wahid Abu-Amer ◽  
Gail Pashos ◽  
Cecilia Pascual Garrido ◽  
...  
Keyword(s):  
Disease Progression ◽  
Femoroacetabular Impingement ◽  
External Rotation ◽  
Univariate Analysis ◽  
Alpha Angle ◽  
Hip Osteoarthritis ◽  
Symptom Development ◽  
Ucla Activity Score ◽  
Center Edge ◽  
Imaging Characteristics

Introduction: Femoroacetabular Impingement (FAI) is one of the most common causes of hip osteoarthritis. Nevertheless, the factors contributing to symptom development and FAI disease progression are poorly understood. Hypothesis/Purpose: The purpose of this study was to (1) investigate rates of initial and subsequent symptom development in the contralateral hip of patients with FAI, and (2) identify predictors of disease progression (symptom development) in the contralateral hip. Methods: This prospective study included a minimum 5 year follow-up of the contralateral hip in 179 patients undergoing FAI surgery. Symptoms (moderate pain) were monitored over the study course. Univariate analysis compared patient and FAI imaging characteristics of patients developing symptoms to those who remained asymptomatic. Results: 146 patients (146 hips, 81.5%) were included (min 5 year, mean 6.7 years). Thirty-nine (26%) presented with symptoms in the contralateral hip while 34 (23%) developed symptoms. Head-neck offset ratio (HNOR) on AP pelvis radiographs was significantly lower among hips that developed symptoms (0.164 vs. 0.153 p=0.025). Maximum alpha angle (p=0.413), lateral center edge angle (p=0.704), and crossover sign (p=0.115) were not predictive of symptoms. Patients with a UCLA activity score greater than 9 were less likely to develop symptoms (14% vs. 46%, p=0.081), but this was not statistically significant. The total arc of rotation in extension (35.740 vs 45.140, p=0.012) and 900 of flexion (40.00 vs 50.800, p=0.009) as well as external rotation at 900 of flexion (28.940 vs 36.590, p=0.020) were decreased in hips developing symptoms. Internal Rotation in flexion was not significantly decreased in symptomatic patients (11.060 vs 14.20, p=0.113). Conclusions: We identified unique radiographic and physical exam findings that are associated with symptom development in patients with FAI. Specifically, decreased hip rotation arc and decreased HNOR were strongly associated with disease progression and may represent important factors for future risk modeling in FAI patients.

scholarly journals Identification of Factors Associated with Disease Progression in the Contralateral Hip of Patients with Symptomatic Femoroacetabular Impingement. (139)

2021 ◽  
Vol 9 (10_suppl5) ◽  
pp. 2325967121S0027
Author(s):  
Adam Khan ◽  
Craig Louer ◽  
Wahid Abu-Amer ◽  
Gail Pashos ◽  
Cecilia Pascual Garrido ◽  
...  
Keyword(s):  
Disease Progression ◽  
Femoroacetabular Impingement ◽  
External Rotation ◽  
Alpha Angle ◽  
Hip Osteoarthritis ◽  
Symptom Development ◽  
Ucla Activity Score ◽  
Center Edge ◽  
Imaging Characteristics

Objectives: Femoroacetabular Impingement (FAI) is one of the most common causes of hip osteoarthritis. Nevertheless, the factors contributing to symptom development and FAI disease progression are poorly understood. The purpose of this study was to (1) investigate rates of symptom development in the contralateral hip of patients with FAI at mid-term follow-up, and (2) identify predictors of disease progression (symptom development) in the contralateral hip. Methods: This prospective study included 179 patients undergoing ipsilateral FAI surgery with no history of previous contralateral hip surgery. In the current study, the contralateral hip was assessed at minimum 5 year follow-up. Symptoms (defined as moderate pain) and the need for surgery were monitored over the study course. Statistical analysis compared patient and FAI imaging characteristics of patients developing symptoms to those who remained asymptomatic. Results: A total of 146 hips (81.5%) were included at a mean 6.7 years of follow-up. Thirty-nine (26.7%) presented with symptoms in the contralateral hip, while an additional 35 (23.9%) developed symptoms during the follow-up period. Twenty-Six (17.8%) progressed to surgery for their contralateral hip. Head-neck offset ratio (HNOR) on AP pelvis radiographs was significantly lower among hips that developed symptoms (0.16 vs. 0.15 p=0.03). Maximum alpha angle (p=0.41), lateral center edge angle (p=0.70), and crossover sign (p=0.12) were not predictive of symptoms. Patients with a UCLA activity score greater than 9 were less likely to develop symptoms (14% vs. 46%, p=0.081), but this was not statistically significant. The total arc of rotation in 90° of flexion (40.0° vs 50.8°, p=0.01) as well as external rotation at 900 of flexion (28.9° vs 36.6°, p=0.02) were decreased in hips developing symptoms. Internal rotation in flexion was not significantly decreased in symptomatic patients (11.1° vs 14.2°, p=0.11). Kaplan Meier survival analysis demonstrated 53% and 45% of patients remaining asymptomatic at 5 and 8 year time points (Figure). Conclusions: At a mean follow-up of 6.7 years, significant symptoms in the contralateral hip of patients with FAI are present in 50.7% of patients, while 49.3% remain asymptomatic or minimally symptomatic. We identified unique radiographic and physical exam findings that are associated with symptom development in patients with FAI. Specifically, decreased hip rotation arc and decreased HNOR were strongly associated with disease progression and may represent important factors for future risk modeling in FAI patients.

scholarly journals A Prospective Analysis of the Contralateral Hip Among Patients With Femoroacetabular Impingement: What Are the Risk Factors for Disease Progression?

2018 ◽  
Vol 46 (10) ◽  
pp. 2486-2491 ◽  
Author(s):  
Craig R. Louer ◽  
Gail Pashos ◽  
John C. Clohisy ◽  
Jeffrey J. Nepple
Keyword(s):  
Disease Progression ◽  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Activity Level ◽  
Study Cohort ◽  
Symptom Development ◽  
Crossover Sign ◽  
Kaplan Meier ◽  
Head Neck

Background: The pathophysiology of femoroacetabular impingement (FAI) remains to be better understood, including factors affecting symptom development and disease progression. Purpose: (1) To determine rates of initial and subsequent symptom development in the contralateral hip of patients with symptomatic FAI and (2) to identify predictors of the development of symptomatic contralateral FAI. Study Design: Case-control study; Level of evidence, 3. Methods: This prospective study cohort included the contralateral hip of 179 consecutive patients undergoing primary surgical treatment of FAI. At presentation and follow-up time points, patients recorded the presence of symptoms in the contralateral hip. Patients with a minimum 1-year follow-up were included in the final cohort. Univariate analysis compared the patient characteristics and FAI imaging characteristics (cam and pincer) of initially asymptomatic patients who developed symptoms and those who remained asymptomatic. Kaplan-Meier survival curves were calculated to demonstrate symptom development over time. Results: A total of 148 patients (83%) were followed for at least 1 year (mean, 2.9 years). Thirty-four (23%) patients had symptoms in the contralateral hip at the time of the initial presentation. An additional 27 hips (24% of the initially asymptomatic) developed symptoms during the follow-up period at a mean 2.0 years from presentation. Head-neck offset ratio on the anteroposterior pelvis radiograph was significantly lower among hips that developed symptoms (0.153 vs 0.163 asymptomatic group, P = .027). Maximum alpha angle ( P = .503), lateral center edge angle ( P = .975), and crossover sign ( P = .865) were not predictive of the development of symptoms. Patients developing contralateral hip symptoms were less likely to have a UCLA (University of California, Los Angeles) activity score of 9 or 10 at presentation (18.2% vs 43.8%, P = .032). The total arc of rotation in flexion (internal rotation in 90° of flexion + external rotation in flexion) was significantly decreased in hips developing symptoms (39.4º vs 50.4º, P = .012). Kaplan-Meier survival analysis demonstrated that 72%, 67%, 56%, and 48% of all patients remained asymptomatic at 1, 2, 3, and 4 years, respectively. Conclusion: Approximately 1 in 4 patients with FAI presents with symptoms in the contralateral hip, and an additional 1 in 4 patients develops significant symptoms in the following 4 years. Several factors, including low activity level, less hip rotational motion, and decreased head-neck offset ratio, were significantly associated with the development of symptoms, while the alpha angle and crossover sign were not.

scholarly journals Prevalence of Morphological Variations Associated With Femoroacetabular Impingement According to Age and Sex: A Study of 1878 Asymptomatic Hips in Nonprofessional Athletes

2021 ◽  
Vol 9 (2) ◽  
pp. 232596712097789
Author(s):  
Rodolfo Morales-Avalos ◽  
Adriana Tapia-Náñez ◽  
Mario Simental-Mendía ◽  
Guillermo Elizondo-Riojas ◽  
Michelle Morcos-Sandino ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Cross Sectional Study ◽  
Level Of Evidence ◽  
Crossover Sign ◽  
Cross Sectional ◽  
Radiographic Findings ◽  
Morphological Variations ◽  
Pelvic Radiographs ◽  
Center Edge

Background: Radiographic findings related to the cam and pincer variants of femoroacetabular impingement (FAI) include measurements of the alpha angle and lateral center-edge angle (LCEA). The function of these radiographic findings has been put into question because of high heterogeneity in reported studies. Purpose: The aim of this study was 3-fold: (1) to determine the prevalence of cam and pincer variants according to sex and age on anteroposterior (AP) pelvic radiographs from an asymptomatic nonathletic population, (2) to identify the most common radiographic signs of cam- and pincer-type variants, and (3) to determine if there are variations in the prevalence of these radiographic signs according to sex and age. Study Design: Cross-sectional study; Level of evidence, 3. Methods: There were 3 independent observers who retrospectively analyzed the 939 AP pelvic radiographs (1878 hips) of patients aged 18 to 50 years who did not have hip symptoms and who were not professional athletes. The prevalence of the cam and pincer variants according to the alpha angle and LCEA, respectively, and the presence of other radiographic signs commonly associated with these variables were determined in the overall population and by subgroup according to sex and age group (18-30, 31-40, and 41-50 years). Descriptive and inferential statistics were used to analyze the study sample. Results: The mean age of the included population was 31.0 ± 9.2 years, and 68.2% were male. The prevalence of the cam-type variant was 29.7% (558/1878), and that of the pincer-type variant was 24.3% (456/1878). The radiographic signs that were most associated with the cam and pincer variants were a pistol-grip deformity and the crossover sign, respectively. Significant differences ( P < .001) in the prevalence of these variants were identified between men and women in both variants. No differences were observed in the alpha angle or LCEA according to sex or age. Conclusion: Radiographic findings suggestive of FAI had significant variations with respect to sex and age in this study sample. This study provides information to determine the prevalence of these anatomic variants in the general population.

The Prevalence of Radiographic Findings of Structural Hip Deformities for Femoroacetabular Impingement in Patients With Hip Pain

2020 ◽  
Vol 48 (3) ◽  
pp. 647-653 ◽  
Author(s):  
Jun Zhou ◽  
Heath P. Melugin ◽  
Rena F. Hale ◽  
Devin P. Leland ◽  
Christopher D. Bernard ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Mixed Type ◽  
Imaging Modality ◽  
Alpha Angle ◽  
Young Patients ◽  
Radiographic Finding ◽  
Hip Pain ◽  
Radiographic Findings ◽  
Protrusio Acetabuli ◽  
Center Edge

Background: Radiography is the initial imaging modality used to evaluate femoroacetabular impingement (FAI), and diagnostic radiographic findings are well-established. However, the prevalence of these radiographic findings in patients with hip pain is unknown. Purpose: The purpose was 3-fold: (1) to determine the overall prevalence of radiographic FAI deformities in young patients presenting with hip pain, (2) to identify the most common radiographic findings in patients with cam-type FAI, and (3) to identify the most common radiographic findings in patients with pincer-type FAI. Study Design: Cross-sectional study; Level of evidence, 3. Methods: A geographic database was used to identify patients aged 14 to 50 years with hip pain between the years 2000 to 2016. The following were evaluated on radiographs: cam type: typical pistol grip deformity, alpha angle >55°; pincer type: crossover sign (COS), coxa profunda or protrusio acetabuli, lateral center edge angle (LCEA) ≥40°, Tönnis angle <0°; and mixed type: both cam- and pincer-type features. Posterior wall sign (PWS) and ischial spine sign (ISS) were also evaluated. The prevalence of each was determined. Descriptive statistics were performed on all radiographic variables. Results: There were 1893 patients evaluated, and 1145 patients (60.5%; 1371 hips; 374 male and 771 female; mean age, 28.8 ± 8.4 years) had radiographic findings consistent with FAI. Of these hips, 139 (10.1%) had cam type, 245 (17.9%) had pincer type, and 987 (72.0%) had mixed type. The prevalence of a pistol grip deformity and an alpha angle >55° was 577 (42.1%) and 1069 (78.0%), respectively. The mean alpha angle was 66.9°± 10.5°. The prevalence of pincer-type radiographic findings was the following: COS, 1062 (77.5%); coxa profunda, 844 (61.6%); ISS, 765 (55.8%); PWS, 764 (55.7%); Tönnis angle <0°, 312 (22.8%); LCEA ≥40°, 170 (12.4%); and protrusio acetabuli, 7 (0.5%). Conclusion: The overall prevalence of radiographic findings consistent with FAI in young patients with hip pain was 60.5%. Radiographic findings for mixed-type FAI were the most prevalent. The most common radiographic finding for cam-type FAI was an alpha angle >55°. The most common radiographic finding for pincer-type FAI was the COS.

scholarly journals Pre-operative and Post-Operative Alpha Angles are Significant Independent Predictors of Patient-Reported Outcome Measures at Two Years After Hip Arthroscopy

2018 ◽  
Vol 6 (7_suppl4) ◽  
pp. 2325967118S0017
Author(s):  
Drew A. Lansdown ◽  
Kyle Kunze ◽  
Gift Ukwuani ◽  
Brian Robert Waterman ◽  
William H. Neal ◽  
...  
Keyword(s):  
Hip Arthroscopy ◽  
Univariate Analysis ◽  
Arthroscopic Surgery ◽  
Alpha Angle ◽  
Joint Space Width ◽  
Postoperative Outcomes ◽  
Harris Hip Score ◽  
Multivariate Modeling ◽  
Center Edge ◽  
Patient Reported

Objectives: Residual impingement after hip arthroscopy for femoroacetabular impingement (FAI) is a common cause for re-operation; however, the relationship between preoperative and postoperative radiographic parameters and patient-reported outcomes has not been defined. Methods: 749 consecutive patients were reviewed two years after primary hip arthroscopy. Patients undergoing revision surgery were excluded. Pre-operative and post-operative radiographs were analyzed to measure the alpha angle on standardized anteroposterior (AP) pelvis, Dunn-lateral, and false profile (FP) views and anterior and lateral center-edge angles (ACEA, LCEA). Univariate analysis evaluated the association between demographic variables, radiographic measures and hip outcome scores (Hip Outcome Score (HOS)-Activities of Daily Living (ADL), HOS-Sports Specific (SS), and Modified Harris Hip Score (mHHS)). Multivariate modeling was subsequently performed. Significance was defined as p<0.05. Results: 706 patients with mean age of 33.2±12.3 years and mean BMI 25.1± 5kg/m2 were included for final analysis. The alpha angle on the AP, Dunn-lateral, and FP views and the ACEA and LCEA decreased after surgery (p<0.001 for all). Significant univariate correlations with the postoperative HOS-ADL included age, BMI, pre-operative AP, FP, and Dunn and postoperative FP alpha angles. Postoperative HOS-SS was correlated with age, BMI, medial post-operative joint space width (JSW), pre-operative AP, FP, and Dunn and postoperative FP alpha angles, and pre-operative and post-operative (ACEA). Postoperative mHHS correlated with age, BMI, post-operative lateral JSW, pre-operative AP, FP, and Dunn and postoperative FP and Dunn alpha angles, and post-operative ACEA. Multivariate modeling (Table 2) demonstrated that preoperative and postoperative FP alpha angles were independent predictors of postoperative outcomes. Conclusion: Pre-operative and post-operative alpha angles were negatively correlated with the HOS-ADL, HOS-SS, and mHHS at 2 years after arthroscopic surgery for FAI. Specifically, pre-operative and postoperative FP alpha angles were independent predictors of postoperative outcomes. These results highlight the importance of resecting anterior cam lesions to prevent residual impingement and inferior outcomes. [Table: see text]

Prevalence of radiographic parameters on CT associated with femoroacetabular impingement in a Chinese asymptomatic population

2020 ◽  
Vol 61 (9) ◽  
pp. 1213-1220
Author(s):  
Jing Chen ◽  
Lei Xu ◽  
Zhe-feng Chen ◽  
Yue-fen Zou
Keyword(s):  
Femoroacetabular Impingement ◽  
Elderly Women ◽  
Alpha Angle ◽  
Ct Images ◽  
Chinese Patients ◽  
Predisposing Factor ◽  
Imaging Evaluation ◽  
Center Edge ◽  
Asymptomatic Patients ◽  
Sector Angle

Background Imaging evaluation of femoroacetabular impingement (FAI) plays a major role in early diagnosis and treatment, preventing irreversible degenerative changes in hip joints. Purpose To investigate the anatomical parameters associated with FAI in a Chinese asymptomatic population by computed tomography (CT) and to evaluate the prevalence of the radiographic features of cam and pincer types in Chinese patients. Material and Methods We reviewed the CT images of 470 hips in 235 Chinese patients who underwent abdominal and pelvic CT scans for reasons unrelated to hip symptoms at our hospital between February and October 2017. The following measurements were made on each hip joint: acetabular version angle (AV); anterior acetabular sector angle (AASA); posterior acetabular sector angle (PASA); the lateral center edge angle (LCE); the alpha angle (AA); and femoral head-neck offset (FHNO). Results Significant differences in all parameters were seen between men and women. Young men and elderly women showed more retroversion in our study. LCE, AA, and FHNO were all larger in men than women. The data showed 25% of female joints and 34.5% of male joints had at least one predisposing factor for FAI using measurement parameters by CT images in Chinese asymptomatic patients, and the prevalence of pincer lesion (19.1%) was larger than cam lesion (9.1%). Conclusion Morphological features associated with FAI are also present in Chinese asymptomatic patients. The threshold values for abnormal parameters should be reconsidered based on gender, age, and other factors in order to improve the accuracy of diagnosis.

scholarly journals Hip center edge angle and alpha angle correlate with gait variables in femoroacetabular impingement morphology (919.11)

2014 ◽  
Vol 28 (S1) ◽  
Author(s):  
Gary Farkas ◽  
Marc Haro ◽  
Simon Lee ◽  
Alejandro Espinoza Orias ◽  
Shane Nho
Keyword(s):  
Femoroacetabular Impingement ◽  
Alpha Angle ◽  
Edge Angle ◽  
Center Edge ◽  
Center Edge Angle

scholarly journals SQUATTING MECHANICS FOLLOWING AN OSTEOCHONDROPLASTY FOR IDIOPATHIC FEMOROACETABULAR IMPINGEMENT

2019 ◽  
Vol 7 (3_suppl) ◽  
pp. 2325967119S0015
Author(s):  
Henry B. Ellis ◽  
Amanda L. Fletcher ◽  
Kirsten Tulchin-Francis ◽  
Alex Loewen ◽  
Anthony Anderson ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
External Rotation ◽  
Alpha Angle ◽  
Hip Dislocation ◽  
Lower Limbs ◽  
Entire Cohort ◽  
Average Decrease ◽  
One Year ◽  
Hip Flexion ◽  
Hip Rotation

Background: Femoroacetabular impingement (FAI) is primarily due to the repetitive motion of aberrant bone in provocative positions such as hip flexion and internal rotation (IR). The purpose of this study is to evaluate the kinematic changes that occur in the hip during a squat prior to and following an osteochondroplasty for idiopathic FAI. Methods: Subjects were prospectively enrolled when scheduled to undergo hip preservation surgery for primary CAM hip impingement by one of 3 surgeons. Prior to the procedure, subjects were evaluated in the movement science lab while performing a standardized bilateral limb gravity squat. Kinematic data of the trunk, pelvis and lower limbs were analyzed during the descent phase of the squat. Statistical comparison of the operative and non-operative hips was performed prior to and at a minimum of one year following surgery. Results: Twenty-seven hips with a mean age of 16.3 years (12.4 – 19.9 years, 8 males) underwent an osteochondroplasty (8 arthroscopic, 19 surgical hip dislocation) resulting in a decrease in the alpha angle (60.8° versus 46.8°, p<0.001) and a significant improvement in HOOS and UCLA scores. When combining the entire cohort, no statistical difference was seen in side to side nor pre-operative to post-operative kinematic or kinetic data. Asymmetry was seen in the transverse plane hip rotation with 6/27 subjects demonstrating an average reduction of 9.4° in ROM on the affected side and a decrease in both peak IR and external rotation (ER) (average decrease 4.7°). Following osteochondroplasty, asymmetry resolved in 4/6 patients. Also, 16/27 subjects demonstrated asymmetry in rotation at 40° of hip flexion during the squat (11 more ER, 5 more IR) in which 37.5% had resolution of the asymmetry following an osteochondroplasty. Conclusion: Asymmetry in squatting mechanics in patients with FAI is not consistent with all subjects. Those with asymmetry in rotation at 40° of hip flexion during the squat or reduction in overall hip rotation may see a resolution in asymmetry following an osteochondroplasty. Dynamic impingement may present as asymmetry during different positions of hip flexion in a squat.

scholarly journals Are there Sex differences in Return to Play Rates in High Level Athletes Following Hip Arthroscopy?

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0042
Author(s):  
Matthew Dooley ◽  
Joost Burger ◽  
Bryan Kelly ◽  
Eilish O’Sullivan
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Arthroscopy ◽  
Female Athletes ◽  
Alpha Angle ◽  
Return To Sport ◽  
Collegiate Athletes ◽  
Return To Play ◽  
Center Edge ◽  
Significant Difference ◽  
High Level

Objectives: Return to sport is a common co ncern in those undergoing arthroscopic surgery for the treatment of femoroacetabular impingement. These are commonly young active individuals with high-level athletic aspirations. Setting expectations in terms of appropriate time frame and success rates are an integral piece of pre-operative education and planning. The goals of this study were to examine return to play (RTP) rates and time frames in professional and collegiate athletes following hip arthroscopy, evaluate sex differences in return to play (morphology and rates), and evaluate differences in return to play for the most common sports. Methods: A retrospective review of a continuous cohort of patients undergoing hip arthroscopy for the treatment of femoroacetabular impingement and labral injury was conducted between January 2014 and December 2018. Athletes whom were participating in collegiate or professional sports prior to surgery were included. Chart review was conducted to gather sport specific information, morphologic data, clearance dates, successful return, and subsequent surgery. Successful return to sport was determined by being able to return to participation following clearance in at least one season. Descriptive statistics were utilized to summarize the data set and chi-square and t-tests were utilized to examine differences between groups. Results: 265 patients undergoing 332 hip arthroscopies participating in collegiate or professional sports prior to surgery were identified (75.4% male and 24.6% female), with 237 collegiate athletes and 95 professional athletes. There was a significant difference in mean alpha angles between males and females, 70.2 ± 10.5 males and 60.7± 10.0 in females, (p<0.001), but no significant differences in coronal center edge angles or femoral version. 87% of the athletes participated in hockey, football, lacrosse, soccer, baseball, soccer, or basketball. Given that a significant portion of the athletes were in college, there was a portion that graduated and thus no longer participated in collegiate athletics (27 hips), and 3 athletes (all with bilateral hip arthroscopies) were unable to return to sport due to other conditions. 91.9% of athletes were able to return to sport. 19 athletes (22 hips) were unable to return to sport. The group that was unable to return was predominantly female (73%), and this difference was significant (p<0.001). There was a significant difference between the returning group and the group that failed to return to sport in alpha angle (RTP 68.6 ± 10.8 vs No RTP 60.7± 10.6), but there were no differences in coronal center edge angle or femoral version. The difference in alpha angle is due to the predominance of females (whom had significantly lower alphas) in the unable to return group. 10 athletes (11 hips, 3.3%) required subsequent surgery (revision arthroscopy, conversion to periacetabular osteotomy, or hip resurfacing). Times for return to play were available to 205 of the athletes, averaging 6.8 months± 2.8. There was no significant difference between the males and females for return to play. There was trend towards shorter length of return for hockey athletes. There was a significant difference in the return to sport rates between the sport groups, but there were some groups with smaller sample sizes that should be taken into account. The groups with more athletes unable to return were soccer and lacrosse; these sports also had a high number of female athletes. There were no hockey athletes that were unable to return, and only 1 football athlete was unable to return. Conclusions: Hip arthroscopy for the treatment of femoroacetabular impingement and labral injury allows patients to return to sport at a high level within an average of 6.8 months. However, female athletes are less likely to have a successful return and should potentially be counseled as such. This may also inform pre-operative rehabilitation programs and intra-operative planning for female athletes. Further research should examine causes for decreased rate of return for females, and potential ways to maximize recovery and return to sport following hip arthroscopy. [Table: see text]

scholarly journals Morphological Changes of the Hip Commonly Associated With Femoroacetabular Impingement Are Not Correlated With Rotational Range of Hip Motion in Elite Soccer Athletes

2021 ◽  
pp. 194173812097366
Author(s):  
André Orlandi Bento ◽  
Guilherme Falótico ◽  
Keelan Enseki ◽  
Ronaldo Alves Cunha ◽  
Benno Ejnisman ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Lower Limb ◽  
Clinical Relevance ◽  
Morphological Changes ◽  
Alpha Angle ◽  
Soccer Players ◽  
Level Of Evidence ◽  
Rotational Movement ◽  
Professional Soccer ◽  
Significant Difference

Background: Morphological changes characteristic of femoroacetabular impingement (FAI) are common in soccer players. However, the clinical relevance of such anatomical variations is still not well-defined. Hypothesis: We hypothesized that high alpha angle values and/or acetabular retroversion index (ARI) are correlated with rotational range of motion (ROM) of the hip and that there are clinical-radiological diferences between the dominant lower limb (DLL) and nondominant lower limb (NDLL) in professional soccer players. Study Design: Cross-sectional. Level of Evidence: Level 3. Methods: A total of 59 male professional soccer players (average age 25.5 years, range 18-38 years) were evaluated in the preseason. As main outcome measures, we evaluated the alpha angle and the ARI and hip IR and ER ROM with radiographic analysis. Results: The measurements taken on DLL and NDLL were compared and a significant difference was found between the sides in the ER ( P = 0.027), where the DLL measures were 1.54° (95% CI, 0.18-2.89) greater than the NDLL. There were no significant differences between the sides in the measures of IR ( P > 0.99), total ROM ( P = 0.07), alpha angle ( P = 0.250), and ARI ( P = 0.079). The correlations between the rotation measurements and the alpha angle in each limb were evaluated and the coefficient values showed no correlation; so also between the ARI and rotation measures. Conclusion: Morphological changes of the femur or acetabulum are not correlated with hip IR and ER ROM in male professional soccer players. ER on the dominant side was greater than on the nondominant side. There was no significant difference in the other measurements between sides. Clinical Relevance: In clinical practice, it is common to attribute loss of hip rotational movement to the presence of FAI. This study shows that anatomical FAI may not have a very strong influence on available hip rotational movement in professional soccer athletes.

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