Surgical Correction of Cam Deformity in Association with Femoroacetabular Impingement and Its Impact on the Degenerative Process within the Hip Joint

2017 ◽  
Vol 99 (16) ◽  
pp. 1373-1381 ◽  
Author(s):  
Paul E. Beaulé ◽  
Andrew D. Speirs ◽  
Helen Anwander ◽  
Gerd Melkus ◽  
Kawan Rakhra ◽  
...  
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Surgical Correction ◽  
Degenerative Process ◽  
Cam Deformity

scholarly journals Hip Joint Torsional Loading Before and After Cam Femoroacetabular Impingement Surgery

2018 ◽  
Vol 47 (2) ◽  
pp. 420-430 ◽  
Author(s):  
K.C. Geoffrey Ng ◽  
Hadi El Daou ◽  
Marcus J.K. Bankes ◽  
Ferdinando Rodriguez y Baena ◽  
Jonathan R.T. Jeffers
Keyword(s):  
Internal Rotation ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
External Rotation ◽  
Joint Mechanics ◽  
External Torque ◽  
Cam Deformity ◽  
Capsular Repair ◽  
Applied Torque ◽  
Cam Resection

Background: Surgical management of cam femoroacetabular impingement (FAI) aims to preserve the native hip and restore joint function, although it is unclear how the capsulotomy, cam deformity, and capsular repair influence joint mechanics to balance functional mobility. Purpose: To examine the contributions of the capsule and cam deformity to hip joint mechanics. Using in vitro, cadaveric methods, we examined the individual effects of the surgical capsulotomy, cam resection, and capsular repair on passive range of motion and resistance of applied torque. Study Design: Descriptive laboratory study. Methods: Twelve cadaveric hips with cam deformities were skeletonized to the capsule and mounted onto a robotic testing platform. The robot positioned each intact hip in multiple testing positions: (1) extension, (2) neutral 0°, (3) flexion 30°, (4) flexion 90°, (5) flexion-adduction and internal rotation (FADIR), and (6) flexion-abduction and external rotation. Then the robot performed applicable internal and external rotations, recording the neutral path of motion until a 5-N·m of torque was reached in each rotational direction. Each hip then underwent a series of surgical stages (T-capsulotomy, cam resection, capsular repair) and was retested to reach 5 N·m of internal and external torque again after each stage. During the capsulotomy and cam resection stages, the initial intact hip’s recorded path of motion was replayed to measure changes in resisted torque. Results: Regarding changes in motion, external rotation increased substantially after capsulotomies, but internal rotation only further increased at flexion 90° (change +32%, P = .001, d = 0.58) and FADIR (change +33%, P < .001, d = 0.51) after cam resections. Capsular repair provided marginal restraint for internal rotation but restrained the external rotation compared with the capsulotomy stage. Regarding changes in torque, both internal and external torque resistance decreased after capsulotomy. Compared with the capsulotomy stage, cam resection further reduced internal torque resistance during flexion 90° (change −45%, P < .001, d = 0.98) and FADIR (change −37%, P = .003, d = 1.0), where the cam deformity accounted for 21% of the intact hip’s torsional resistance in flexion 90° and 27% in FADIR. Conclusion: Although the capsule played a predominant role in joint constraint, the cam deformity provided 21% to 27% of the intact hip’s resistance to torsional load in flexion and internal rotation. Resecting the cam deformity would remove this loading on the chondrolabral junction. Clinical Relevance: These findings are the first to quantify the contribution of the cam deformity to resisting hip joint torsional loads and thus quantify the reduced loading on the chondrolabral complex that can be achieved after cam resection.

scholarly journals Pathohistologic Changes in Hip Tissues and Clinical-Morphologic Correlations in Diseases Complicated by Femoroacetabular Impingement Syndrome

2014 ◽  
Vol 21 (2) ◽  
pp. 67-73
Author(s):  
V. V Grigorovskiy ◽  
V. V Filipchuk ◽  
M. S Kabatsiy
Keyword(s):  
Femoral Head ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Comparison Study ◽  
Acetabular Labrum ◽  
Aseptic Necrosis ◽  
Association Coefficient ◽  
Absolute Value ◽  
Femoroacetabular Impingement Syndrome ◽  
Fai Syndrome

The purpose of the work was to detect clinical-morphologic correlative dependences in patients with clinically marked femoroacetabular impingement (FAI) syndrome basing on the study of pathomorphologic changes in hip joint tissues, semiquantitative quantification of pathologic changes intensity, frequency analysis of their occurrence in nosologic groups of comparison. Study was performed on specimens of hip joint tissues - femoral head, acetabulum, acetabular labrum and joint capsule, resected during indicated corrective surgeries for femoral head aseptic necrosis and juvenile epiphysiolysis. Clinical-morphologic study revealed various pathologic changes: dystrophic-destructive, ischemic-necrotic and productive-inflammatory. In patients with FAI syndrome clinical and morphologic correlative dependences varied by absolute value, sign and degree of reliability of association coefficient parameters, i.e. groups of patients with certain nosologic units retained the peculiarities of rate and characteristics proportions in correlative dependences

scholarly journals Bone density changes following surgical correction of femoroacetabular impingement deformities

2018 ◽  
Vol 26 (12) ◽  
pp. 1683-1690 ◽  
Author(s):  
A.D. Speirs ◽  
K.S. Rakhra ◽  
M.-J. Weir Weiss ◽  
P.E. Beaulé
Keyword(s):  
Bone Density ◽  
Femoroacetabular Impingement ◽  
Surgical Correction

scholarly journals Paper 7: Effect of Cam-Type Femoroacetabular Impingement on Hip Joint Kinematics

2012 ◽  
Vol 28 (6) ◽  
pp. e46-e47
Author(s):  
Michael Kenneth Gilbart ◽  
Laura Callan ◽  
David R. Wilson
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Joint Kinematics

scholarly journals Differences in Hip Joint Biomechanics and Muscle Activation in Individuals With Femoroacetabular Impingement Compared With Healthy, Asymptomatic Individuals: Is Level-Ground Gait Analysis Enough?

2018 ◽  
Vol 6 (5) ◽  
pp. 232596711876982 ◽  
Author(s):  
Derek J. Rutherford ◽  
Janice Moreside ◽  
Ivan Wong
Keyword(s):  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Muscle Activation ◽  
Gluteus Maximus ◽  
Knee Extensors ◽  
Joint Function ◽  
Asymptomatic Group ◽  
Level Walking ◽  
Hip Function ◽  
Asymptomatic Individuals

Background: Femoroacetabular impingement (FAI) is a recognized cause of hip and groin pain and a significant factor in hip joint function during sport. Objective tests for understanding hip function are lacking in this population. Purpose: To determine whether biomechanical and electromyographic features of hip function during level-ground walking differ between a group diagnosed with FAI and those with no symptoms of FAI. Study Design: Controlled laboratory study. Methods: A total of 20 asymptomatic individuals and 20 individuals with FAI walked on a dual-belt instrumented treadmill at self-selected walking velocities. Sagittal and frontal plane joint motions, moments, and muscle activation for the gluteus medius, gluteus maximus, rectus femoris, and medial and lateral hamstrings were analyzed. Discrete measures were extracted from each biomechanical waveform, and principal component analysis was used to determine hip joint muscle activation and hip adduction moment patterns. Statistical significance was determined by use of Student t tests with Bonferroni adjustments for multiple comparisons (α = .05). Results: Individuals with FAI walked more slowly ( P = .015) and had lower self-reported function ( P < .001). No differences in muscle strength were found between the symptomatic and contralateral legs in the FAI group ( P > .017), but those with FAI had lower strength in the knee extensors and flexors and the hip extensors, flexors, and adductors compared with the asymptomatic group ( P < .017). Individuals with unilateral symptomatic FAI walked with similar biomechanical and hip muscle electromyographic results bilaterally. The only differences found were a greater amplitude of gluteus maximus activation in the FAI symptomatic leg compared with the asymptomatic group and greater medial hamstring activation than lateral hamstring activation in the FAI group in both limbs compared with the asymptomatic group. Conclusion: Individuals with FAI were generally deconditioned and reported significantly more functional limitations. No biomechanical differences existed between groups during level walking, yet hamstring and gluteus maximus activation differed when the symptomatic group was compared with the asymptomatic group. Clinical Relevance: The field lacks objective testing of hip joint function to understand implications of FAI for dynamic movements, particularly with applications to biomechanics and electromyography. Level walking was of limited value for understanding FAI hip function, and the development of a more challenging gait assessment is warranted.

scholarly journals Delayed gadolinium-enhanced magnetic resonance imaging (dGEMRIC) of hip joint cartilage in femoroacetabular impingement (FAI): Are pre- and postcontrast imaging both necessary?

2009 ◽  
Vol 62 (6) ◽  
pp. 1362-1367 ◽  
Author(s):  
Bernd Bittersohl ◽  
Harish S. Hosalkar ◽  
Young-Jo Kim ◽  
Stefan Werlen ◽  
Klaus A. Siebenrock ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Joint Cartilage ◽  
Resonance Imaging

Finite element simulations of a hip joint with femoroacetabular impingement

2012 ◽  
Vol 17 (11) ◽  
pp. 1275-1284 ◽  
Author(s):  
J.P. Jorge ◽  
F.M.F. Simões ◽  
E.B. Pires ◽  
P.A. Rego ◽  
D.G. Tavares ◽  
...  
Keyword(s):  
Finite Element ◽  
Femoroacetabular Impingement ◽  
Hip Joint ◽  
Finite Element Simulations
Sign in / Sign up

Export Citation Format

Share Document