Correlation of hip capsule morphology with patient symptoms from femoroacetabular impingement

Abstract

The relationship between morphological characteristics of the hip capsule and patient symptoms in the setting of femoroacetabular impingement (FAI) is undefined. In this study, patients with symptomatic FAI prospectively underwent 3T magnetic resonance (MR) imaging of the affected hip and completed the hip disability and osteoarthritis outcome score (HOOS) to determine the correlation between hip capsule anatomy and patient symptoms. Anterior hip capsule volume, posterior capsule volume, anterior‐posterior capsule volume ratio, and proximal‐distal volume ratio in the anterior capsule were quantified and measured using axial‐oblique intermediate‐weighted 3D fast spin echo MR images. A total of 35 patients (35 hips) were included for analysis (mean age: 30.6 years; mean body mass index [BMI]: 24.9 kg/m2; 57% male). The mean alpha angle was 62.2° ± 4.7°, the mean anterior hip capsule volume was 1705.1 ± 450.3 mm3, the mean posterior hip capsule volume was 1284.8 ± 268.5 mm3, the mean anterior to posterior capsule volume ratio was 1.1 ± 0.39, and the mean proximal to distal volume ratio of the anterior capsule was 0.65 ± 0.28. There was no correlation between age, gender, or BMI, and any hip capsule characteristics. Worse scores on the HOOS pain scale were correlated with increased anterior to posterior volume ratio (r = −.38; 95% confidence interval: −0.06 to −0.63). In conclusion, hip capsule morphology correlates with patient symptoms in the setting of FAI as increased anterior capsular volume, relative to posterior capsular volume, is associated with greater patient pain.

Healing of joint capsule after hip arthroscopy using interportal capsulotomy and capsular closure influences clinical outcomes

“…At present, the influence of capsule healing and characteristics on the clinical outcomes of hip arthroscopy for treatment of FAI is still unknown. Shaw et al evaluated 35 patients with symptomatic FAI and concluded that increased anterior capsular volume is associated with greater preoperative pain [ 13 ]. However, this study did not mention postoperative PROs.…”

“…The iliofemoral ligament is the strongest of the ligaments comprising the hip capsule and plays a significant role in hip stability [ 11 , 12 ]. Shaw et al found that hip capsule morphology correlates with patient symptoms in the setting of femoroacetabular impingement (FAI) as increased anterior capsular volume is associated with greater patient pain [ 13 ]. Nguyen et al thought changes in hip capsule morphology including decreased anterior–posterior capsule thickness ratio after surgery may be correlated with improvements in patient pain, function, and ability to return to sports [ 7 ].…”

There is high variability in quantitative measurement techniques in glenohumeral capsular measurements for shoulder instability: A systematic review

“…The labro-capsular distance is the perpendicular distance between the line 3-4 and the point of the inferior labrum with the highest concavity [14]. need to be considered, which has shown promising results in hip instability [10,23]. For instance, Kay et al reported that capsular thinning correlates with anterior hip instability, making this a promising quantitative marker to implement in the study of capsular pathology for the unstable shoulder [10].…”

Ultrasound had high accuracy in measuring hip joint capsule thickness

“…The joint capsule also plays a crucial role in various biological functions, and its morphology and dimensions to some extent indicate the severity of a patient’s condition [ 3 – 5 ]. Furthermore, arthroscopic surgery is a commonly employed minimally invasive technique in clinical practice for treating various conditions.…”