Correlation of Pelvic Incidence With Cam and Pincer Lesions

Gebhart, Jeremy J.; Streit, Jonathan J.; Bedi, Asheesh; Bush‐Joseph, Charles A.; Nho, Shane J.; Salata, Michael J.

doi:10.1177/0363546514548019

Cited by 67 publications

(62 citation statements)

References 30 publications

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“…Therefore, no predictable, consistent pattern of spur formation can be expected in patients with AAI with associated bony exostoses off the tibia and/or talus. In addition, congenital, bony morphological variants such as squatting talar facets or double tibial facets could in principle predispose to impingement spur formation in the ankle, similar to morphological variants reported for femoroacetabular impingement (Gebhart et al, 2014;Jung et al, 2011;Satinoff, 1972).…”

Section: Discussionmentioning

confidence: 60%

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

2018

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Anterior ankle impingement (AAI) results from repetitive microtrauma leading to pain and decreased dorsiflexion due to spur formation and synovial hypertrophy. Information about the prevalence of anterior spur formation in a large population, and the individual contributions of the talus and tibia to osseous impingement, is limited. A total of 670 ankle specimens from 344 individuals (n = 111 females, n = 233 males) aged 20 to 40 years at the time of death were examined. Matching tibia and talus were opposed and any spurring causing impingement was recorded. Spur locations were measured and ratios calculated to allow for inter-specimen comparison between: (1) medial-to-lateral and anterior-to-posterior spur location versus dimensions of talar neck width, and (2) medial-to-lateral spur location to dimensions of distal anterior tibial width. Differences in spur prevalence in relation to sex, race, height and age were identified by univariant and multivariable statistical analyses. Bony impingement was observed in 21% (n = 72) of specimens, with bilateral involvement in 8% (n = 27). For ankles with AAI, spurs were seen on the talus only in 61%, on the tibia only in 14%, and on both the tibia and talus in 26%. Spurs were significantly more prevalent in males (P = 0.001) and with increasing specimen age (P = 0.002). There were no significant differences related to specimen height or race. Spurs were predominately located on the anterolateral talus (78%) and the anterolateral portion of the distal tibial margin (80%). AAI was present in 21% of young osseous specimens and was significantly more prevalent in males and with increasing specimen age. Clin. Anat., 2018. © 2018 Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 60%

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

2018

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“…Gebhart et al [ 24 ] evaluated 40 cadaveric pelves (80 hips) with photography and manual goniometry and compared PI between hips showing cam- or pincer-related bony abnormalities and hips without those abnormalities. They found that PI was significantly lower in both patterns of FAI compared with controls—43.1° ± 8.6° in 40 cam-FAI hips versus 47.7° ± 9.3° in 40 control hips ( p = 0.02), and 42.5° ± 8.5° in 28 pincer-FAI hips versus 47.0° ± 9.2° in 52 control hips ( p = 0.04).…”

Section: Resultsmentioning

confidence: 99%

Pelvic posture and kinematics in femoroacetabular impingement: a systematic review

Pierannunzii

2017

J Orthop Traumatol

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BackgroundPelvic posture and kinematics influence acetabular orientation and are therefore expected to be involved in the pathomechanics of femoroacetabular impingement (FAI). This systematic review aims to determine whether FAI patients show pelvic postures or patterns of motion contributing to impingement or, conversely, develop compensatory postures and patterns of motion preventing it.Materials and methodsPubMed/MEDLINE, Embase, Google Scholar and the Cochrane Library were systematically searched to find all the studies that measured pelvic positional and/or kinematic data in humans (patients or cadaveric specimens) affected by FAI.ResultsTwelve items were selected and grouped according to the main field of investigation. No quantitative data synthesis was allowed due to methodological heterogeneity. Pelvic posture and kinematics seem to play a relevant role in FAI. The patients, especially if symptomatic, show a paradoxical lack of pelvic back tilt in standing hip flexions, i.e., in squatting, that enhances femoroacetabular engagement. Such an aberrant pattern might depend on a lower pelvic incidence. On the contrary, active hip flexion in decubitus elicits a compensatory, more pronounced back tilt to facilitate hip flexion without impingement. Stair climbing shows a compensatory pattern of augmented pelvic axial rotation and augmented peak forward tilt to reduce painful hip motions, namely internal rotation and extension.ConclusionIn FAI patients, pelvic posture and kinematics are sometimes an expression of compensatory mechanisms developed to reduce pain and discomfort, and sometimes an expression of paradoxical responses that further enhance the impingement pathomechanism.Level of evidenceIV.Electronic supplementary materialThe online version of this article (doi:10.1007/s10195-016-0439-2) contains supplementary material, which is available to authorized users.

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“…8 A decreased pelvic incidence has been related to radiographic signs of FAI, as well. [9][10][11][12] These results suggest that limited range of motion in the spine can alter spinopelvic parameters and subsequently change the joint mechanics of the hip. The article published by Chandrasekaran, Darwish, Suarez-Ahedo, Lodhia, and Domb, 13 "Outcomes of Hip Arthroscopy in Patients With Previous Lumbar Spine Surgery: A Matched-Pair Controlled Cohort Study With Minimum Two-Year Follow Up," brings a good topic of discussion suggesting that patients with a history of lumbar spine surgery undergoing hip arthroscopy should expect improvement in symptoms following surgery.…”

Section: See Related Article On Page 443mentioning

confidence: 88%

Editorial Commentary: The Hip-Spine Connection in Patients Undergoing Hip Arthroscopy: Should We Learn From Total Hip Replacement and Counsel Patients Differently If They Have Had Previous Back Surgery?

Pascual‐Garrido¹

2019

Arthroscopy: The Journal of Arthroscopic & Related Surgery

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Disorders of the adult hip and spine are common, and there is evidence that there is a hip-spine connection in patients with hip femoroacetabular impingement (FAI). Many reports have shown that patients undergoing lumbar fusion and subsequent total hip arthroplasty have a higher risk of complications and worse outcomes following total hip arthroplasty. However, there has been a paucity of research on the effect of a history of lumbar spine surgery in patients undergoing hip arthroscopy for the treatment of FAI. Variations in lumbar lordosis, pelvic incidence, tilt, and sacral slope may modify the degree of FAI, symptoms, and patient-reported outcomes following hip arthroscopy. In the future, we should continue our efforts to better understand the impact that limited range of motion in the spine has in joint mechanics of the hip and the possibility of affecting patient-reported outcomes after hip arthroscopy. Future studies incorporating novel imaging technology, such as EOS, may be an objective way of assessing the effect of abnormal spine-pelvic function in patients with hip FAI.

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Correlation of Pelvic Incidence With Cam and Pincer Lesions

Cited by 67 publications

References 30 publications

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

Prevalence and location of bone spurs in anterior ankle impingement: A cadaveric investigation

Pelvic posture and kinematics in femoroacetabular impingement: a systematic review

Editorial Commentary: The Hip-Spine Connection in Patients Undergoing Hip Arthroscopy: Should We Learn From Total Hip Replacement and Counsel Patients Differently If They Have Had Previous Back Surgery?

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