Unusual case of mixed form of femoroacetabular impingement combined with nonspecyfic synovitis of the hip joint in a young adult: A case report

Introduction. Minimal bone changes in the acetabulum and/or proximal femur, through mechanism known as femoroacetabular impingement, during flexion, adduction and internal rotation lead to early contact between femoral head-neck junction and acetabular brim, in anterosuperior region. Each additional pathological substrate which further decreases specified clearance provokes earlier onset of femoroacetabular impingement symptoms. Case report. We presented a 20-year-old male patient with groin pain, limping, positive impingement test, radiological signs of mixed form of femoroacetabular impingement and unrecognized chronic hypertrophic synovitis with earlier development of clinical hip symptoms than it has been expected. Open surgery of the left hip was done. Two years after the surgery, patient was asymptomatic, painless, and free of motion, with stable x-rays. Conclusion. Hypertrophic synovial tissue further reduces the distance between the femoral head-neck junction and the acetabulum, leading to the earlier onset of femoroacetabular impingement symptoms. Surgical treatment is the method of choice.

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Arthroscopic Treatment of Femoroacetabular Impingement Syndrome with Bone Cyst at Femoral Head-Neck Junction: Case Report and Literature Review

Journal of Cartilage & Joint Preservation ◽

10.1016/j.jcjp.2021.100020 ◽

2021 ◽

pp. 100020

Author(s):

Hong-Jie Huang ◽

Hao Sun ◽

Xin Zhang ◽

Mamtimin Mahmut ◽

Fan Yang ◽

...

Keyword(s):

Case Report ◽

Femoral Head ◽

Literature Review ◽

Femoroacetabular Impingement ◽

Bone Cyst ◽

Impingement Syndrome ◽

Arthroscopic Treatment ◽

Femoroacetabular Impingement Syndrome ◽

Head Neck ◽

Neck Junction

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Sclerotic lesions of the femoral head–neck junction for diagnosis of femoroacetabular impingement

Journal of Orthopaedic Surgery ◽

10.1177/2309499020924161 ◽

2020 ◽

Vol 28 (2) ◽

pp. 230949902092416

Author(s):

Takehito Hananouchi ◽

Stephen Kenji Aoki

Keyword(s):

Femoral Head ◽

Femoroacetabular Impingement ◽

Morphological Characteristics ◽

Control Group ◽

Diagnostic Feature ◽

Pixel Intensity ◽

Plain Radiographs ◽

Sclerotic Lesions ◽

Head Neck ◽

Neck Junction

The morphological characteristics associated with a diagnosis of femoroacetabular impingement (FAI) observed on plain radiographs can also be seen in subjects without hip joint symptoms. Therefore, the purpose of this study was to investigate whether sclerotic lesions on femoral head–neck junction (FHNJ) could be used as a supplemental diagnostic feature. A total of 128 hips from 119 patients (43 male and 76 female) diagnosed with FAI and 24 hips from 21 patients (2 male and 19 female) with other hip pathologies as control were compared in this study. Using standing frog-leg plain radiographs, the prevalence of sclerotic lesions on the FHNJ was established. Additionally, the pixel intensity (PI) of the sclerotic lesions between the FAI and the control groups were quantitatively compared. Sclerotic lesions were present in 96.1% of FAI hips (123 of 128) and only 37.5% of control hips (9 of 24) ( p < 0.05). The ratio of PI in the FAI group was significantly higher (approximately 10%) than in the control group ( p < 0.05). The evaluation of sclerotic lesions may be used as a supplement to aid in the diagnosis of FAI.

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Do Your Routine Radiographs to Diagnose Cam Femoroacetabular Impingement Visualize the Region of the Femoral Head-Neck Junction You Intended?

Arthroscopy The Journal of Arthroscopic and Related Surgery ◽

10.1016/j.arthro.2018.12.031 ◽

2019 ◽

Vol 35 (6) ◽

pp. 1796-1806 ◽

Cited By ~ 9

Author(s):

Keisuke Uemura ◽

Penny R. Atkins ◽

Andrew E. Anderson ◽

Stephen K. Aoki

Keyword(s):

Femoral Head ◽

Femoroacetabular Impingement ◽

Head Neck ◽

Neck Junction

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INFLUENCE OF AGE ON PARAMETERS FOR FEMOROACETABULAR IMPINGEMENT AND HIP DYSPLASIA IN X-RAYS

Acta Ortopédica Brasileira ◽

10.1590/1413-785220172505173951 ◽

2017 ◽

Vol 25 (5) ◽

pp. 197-201 ◽

Cited By ~ 2

Author(s):

ULF-KRISTER HOFMANN ◽

INGMAR IPACH ◽

INA-CHRISTINE RONDAK ◽

ROLAND SYHA ◽

MARCO GÖTZE ◽

...

Keyword(s):

Older Adults ◽

Femoral Head ◽

Hip Dysplasia ◽

Width Ratio ◽

X Rays ◽

Level Of Evidence ◽

Radiographic Diagnosis ◽

Linear Correlations ◽

Head Neck ◽

Neck Junction

ABSTRACT Objective: While several radiographic parameters have been established to describe the geometry and pathology of the hip, their reference values and clinical significance remain a matter of dispute. The present study tests the hypothesis that age has a relevant impact on radiographic hip parameters. Method: Pelvic antero-posterior views were measured for CE angle, Sharp’s angle, acetabular depth-to-width ratio, femoral head extrusion index, roof obliquity, caput-collum-diaphyseal (CCD) angle, and Murray’s femoral head ratio, and the values obtained were correlated with age. Results: Significant weak and moderate linear correlations (all Ps<0.001) were observed between age and CE angle (ρ=0.31), Sharp’s angle (ρ=-0.38), extrusion index (ρ=-0.22), CCD angle (ρ=-0.15), depth-to-width ratio (ρ=-0.38), and roof obliquity (ρ=-0.19), while Murray’s femoral head ratio (ρ=0.05; P=0.274) was not associated with age. Interestingly, the parameters describing the acetabulum all showed a relevant increase in coverage with age, leading to CE-angles well beyond 40° and a Sharp’s angle below 35° in a large portion of asymptomatic older adults. Conclusion: While a decrease in CCD angle with age is described in most orthopedic textbooks, the changes observed with age in acetabular geometry far exceed those measured at the femoral head-neck junction. We recommend considering these alterations that may be attributable to age when formulating a radiographic diagnosis. Level of Evidence III, Diagnostic Studies - Investigating a Diagnostic Test.

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Do Normal Radiographs Exclude Asphericity of the Femoral Head-Neck Junction?

Clinical Orthopaedics and Related Research ◽

10.1007/s11999-008-0617-5 ◽

2008 ◽

Vol 467 (3) ◽

pp. 651-659 ◽

Cited By ~ 128

Author(s):

Marcel Dudda ◽

Christoph Albers ◽

Tallal Charles Mamisch ◽

Stefan Werlen ◽

Martin Beck

Keyword(s):

Femoral Head ◽

Head Neck ◽

Neck Junction

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The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement

Journal of Bone and Joint Surgery - British Volume ◽

10.1302/0301-620x.84b4.0840556 ◽

2002 ◽

Vol 84-B (4) ◽

pp. 556-560 ◽

Cited By ~ 263

Author(s):

H. P. Nötzli ◽

T. F. Wyss ◽

C. H. Stoecklin ◽

M. R. Schmid ◽

K. Treiber ◽

...

Keyword(s):

Femoral Head ◽

Head Neck ◽

Neck Junction

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Femoral head material loss at the head-neck junction in total hip arthroplasty: the effect of head size, stem material and stem offset

Hip International ◽

10.1177/1120700018814473 ◽

2018 ◽

Vol 29 (6) ◽

pp. 647-651 ◽

Cited By ~ 1

Author(s):

Giuseppe Valente ◽

Brent Lanting ◽

Steven MacDonald ◽

Matthew G Teeter ◽

Douglas Van Citters ◽

...

Keyword(s):

Femoral Head ◽

Total Hip Arthroplasty ◽

Hip Arthroplasty ◽

Head Size ◽

Material Loss ◽

Total Hip ◽

Femoral Heads ◽

Measuring Machine ◽

Head Neck ◽

Neck Junction

Introduction:Material loss at the head-neck junction in total hip arthroplasty may cause adverse clinical symptoms and implant failure. The purpose of this study was to quantitatively examine the effects of head size, stem material and stem offset on material loss of the head-neck taper interface of a single trunnion design in retrieval implants of metal on polyethylene bearing surfaces.Methods:A retrieval study was performed to identify all 28-mm and 32-mm femoral heads from a single implant/taper design implanted for >2 years. This included n = 56 of the 28-mm heads and n = 23 of the 32-mm heads. The 28-mm femoral heads were matched to 32-mm femoral heads based on time in vivo and head length. A coordinate measuring machine was used to determine maximum linear corrosion depth (MLD). Differences in MLD for head diameter, stem material, and stem offset were determined.Results:There were no differences between groups for age, gender, BMI, or implantation time. There was no difference in MLD between 28 mm and 32 mm matched paired head diameters ( p = 0.59). There was also no difference in MLD between titanium or cobalt-chromium stems ( p = 0.79), and regular or high-offset stems ( p = 0.95).Conclusion:There is no statistical difference in femoral head MLD at the head-neck junction in THA between 28-mm and 32-mm matched paired femoral heads, similar or mixed alloy coupled femoral head stem constructs, and regular or high offset stems.

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Head-Neck Taper Corrosion in Hip Arthroplasty

BioMed Research International ◽

10.1155/2015/758123 ◽

2015 ◽

Vol 2015 ◽

pp. 1-9 ◽

Cited By ~ 63

Author(s):

S. Hussenbocus ◽

D. Kosuge ◽

L. B. Solomon ◽

D. W. Howie ◽

R. H. Oskouei

Keyword(s):

Femoral Head ◽

Hip Arthroplasty ◽

Design Feature ◽

Review Article ◽

Femoral Head Size ◽

Leg Length ◽

Wear Properties ◽

Femoral Stems ◽

Head Neck ◽

Neck Junction

Modularity at the head-neck junction of the femoral component in THA became popular as a design feature with advantages of decreasing implant inventory and allowing adjustment of leg length, offset, and soft tissue balancing through different head options. The introduction of a new modular interface to femoral stems that were previously monoblock, or nonmodular, comes with the potential for corrosion at the taper junction through mechanically assisted crevice corrosion. The incidence of revision hip arthroplasty is on the rise and along with improved wear properties of polyethylene and ceramic, use of larger femoral head sizes is becoming increasingly popular. Taper corrosion appears to be related to all of its geometric parameters, material combinations, and femoral head size. This review article discusses the pathogenesis, risk factors, clinical assessment, and management of taper corrosion at the head-neck junction.

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