Current trends in sport and exercise hip conditions: Intra-articular and extra-articular hip pain, with detailed focus on femoroacetabular impingement (FAI) syndrome

Kemp, Joanne L; Grimaldi, Alison; Heerey, Joshua J; Jones, D. B.; Scholes, Mark J; Lawrenson, Peter; Coburn, Sally L.; King, M.

doi:10.1016/j.berh.2019.02.006

Cited by 20 publications

(24 citation statements)

References 76 publications

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“…In Figure 1 , we observed that the femoroacetabular pathology has a lower level of pain than in the group of infectious and traumatic pathologies, with statistical significance. In this sense, the study by Kemp [ 31 ], shows that hip pain symptoms with this pathology profile are not an impeding factor for physical activity, which is confirmed by the IPAQ of our study among the subjects in group I.…”

Section: Discussionsupporting

confidence: 87%

“…For each group, the same data were collected so that we could better understand the relationship of these etiologies with comorbidities or with the level of physical activity. In these groups, we did not measure the α and CE angles, as they presented advanced osteoarthritis [ 30 , 31 ]. Comorbidities were recorded as soon as they were included in the study, the most frequent being essential arterial hypertension, diabetes mellitus, systemic lupus erythematosus, asthma, and cirrhosis.…”

Section: Methodsmentioning

confidence: 99%

“…Structural and morphological deformities in the hip joint may be caused by acetabular dysplasia, the loss of sphericity of the femoral head (in the anterolateral portion of the femoral head–neck transition), may be secondary to proximal femoral epiphysiolysis or post-traumatic sequelae [ 29 ]. In advanced stages of hip degeneration, it is not possible to perform the radiographic views that allow one to measure the α angle (between the neck axis and the bone point of the femoral head–neck junction) and LCE angle (lateral center-edge), which allow one to diagnose femoroacetabular impingement and dysplasia [ 30 , 31 ]. In advanced osteoarthritis, there is a deformity (more evident) in the femoral head, a great reduction in the joint space and the formation of osteophytes in the femur and acetabulum [ 9 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

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The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study

et al. 2021

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Background and Objectives: The degenerative pathology of the hip joint appears in young age groups, related to fem-oroacetabular impingement, and in advanced age, due to other inflammatory causes, with greater potential for severity in the presence of comorbidities. Objectives: To evaluate the participation of the main causes of osteoarthritis in relation to physical activities, s Body Mass Index (BMI) and television time (TV). Materials and Methods: 54 patients with surgical indication treated at an orthopedic referral university hospital were stratified into groups (Impact: I, Osteonecrosis/rheumatic: II, Infectious/traumatic: III), and the influence of comorbidities on physical activity performance, relative to BMI and TV time. Results: It was observed that the impact group was the most frequent (51.8%), with 79.6% under the age of 60 years. This group followed the general mean (p < 0.05), using the variables of comorbidity and the level of physical activity. Pain intensity, TV time, BMI showed no correlation with physical activity. Conclusion: Morphostructural changes (group I) represented the most frequent etiological group, and severe pain was common in almost the entire sample. Unlike BMI, comorbidity showed a significant relationship with the level of physical activity.

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Section: Discussionsupporting

confidence: 87%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study

et al. 2021

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“… 1 The morphologies associated with femoroacetabular impingement (FAI) syndrome are potential precursors to hip osteoarthritis (OA), 2 - 6 and the most important contributors to non-arthritic hip pain. 7 - 10 FAI syndrome morphologies are categorized as cam (bony anomaly at the femoral head/head-neck junction), pincer (local or global acetabular overcoverage), and mixed (features of both cam and pincer morphologies). 2…”

Section: Introductionmentioning

confidence: 99%

Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures

et al. 2021

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Aims Cam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-neck contour and acetabular rim in positions of hip flexion combined with rotation is a proposed pathomechanism in these hips, but this has not been studied in active postures. Our aim was to assess the anterior impingement pathomechanism in both active and passive postures with high hip flexion that are thought to provoke impingement. Methods We recruited nine participants with cam and/or pincer morphologies and with pain, 13 participants with cam and/or pincer morphologies and without pain, and 11 controls from a population-based cohort. We scanned hips in active squatting and passive sitting flexion, adduction, and internal rotation using open MRI and quantified anterior femoroacetabular clearance using the β angle. Results In squatting, we found significantly decreased anterior femoroacetabular clearance in painful hips with cam and/or pincer morphologies (mean -11.3° (SD 19.2°)) compared to pain-free hips with cam and/or pincer morphologies (mean 8.5° (SD 14.6°); p = 0.022) and controls (mean 18.6° (SD 8.5°); p < 0.001). In sitting flexion, adduction, and internal rotation, we found significantly decreased anterior clearance in both painful (mean -15.2° (SD 15.3°); p = 0.002) and painfree hips (mean -4.7° (SD 13°); p = 0.010) with cam and/pincer morphologies compared to the controls (mean 7.1° (SD 5.9°)). Conclusion Our results support the anterior femoroacetabular impingement pathomechanism in hips with cam and/or pincer morphologies and highlight the effect of posture on this pathomechanism. Cite this article: Bone Jt Open 2021;2(11):988–996.

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“…Cam and pincer morphologies (CPM), which describe, respectively, an aspherical femoral head/head-neck junction and acetabular over-coverage, are potential precursors to hip osteoarthritis [ 1 – 8 ] and important contributors to non-arthritic hip pain [ 9 – 12 ]. However, only a subset of hips with CPM develops symptoms, which are primarily position-related pain in the hip and/or groin [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Open MRI validation of a hip model driven with subject-specific motion capture data in predicting anterior femoroacetabular clearance

Mohtajeb

Cibere

Graffos

et al. 2021

BMC Musculoskelet Disord

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Background Cam and/or pincer morphologies (CPM) are potential precursors to hip osteoarthritis (OA) and important contributors to non-arthritic hip pain. However, only some CPM hips develop OA and/or pain, and it is not clear why. Anterior impingement between the femoral head/neck contour and acetabular rim during motion is a proposed pathomechanism. Understanding how activity and deformity combine to produce impingement may shed light on the causes of hip degeneration/pain. The objective of this study was to determine the accuracy of a subject-specific hip model driven by subject-specific motion data in predicting anterior impingement. Methods We recruited 22 participants with CPM (both with and without pain) and 11 controls. We collected subject-specific 3D kinematics during squatting and sitting flexion, adduction, and internal rotation (FADIR) (an active and a passive maneuver, respectively, proposed to provoke impingement). We then developed 3D subject-specific hip models from supine 3T hip MRI scans that predicted the beta angle (a measure of anterior femoroacetabular clearance) for each frame of acquired kinematics. To assess the accuracy of these predictions, we measured the beta angle directly in the final position of squatting and sitting FADIR using open MRI scans. We selected the frame of motion data matching the static imaged posture using the least-squares error in hip angles. Model accuracy for each subject was calculated as the absolute error between the open MRI measure of beta and the model prediction of beta at the matched time frame. To make the final model accuracy independent of goodness of match between open MRI position and motion data, a threshold was set for least-squares error in hip angles, and only participants that were below this threshold were considered in the final model accuracy calculation, yielding results from 10 participants for squatting and 7 participants for sitting FADIR. Results For squatting and sitting FADIR, we found an accuracy of 1.1°(0.8°) and 1.3°(mean (SD), and root mean squared error, respectively) and 0.5°(0.3°) and 0.6°, respectively. Conclusion This subject-specific hip model predicts anterior femoroacetabular clearance with an accuracy of about 1°, making it useful to predict anterior impingement during activities measured with motion analysis.

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Current trends in sport and exercise hip conditions: Intra-articular and extra-articular hip pain, with detailed focus on femoroacetabular impingement (FAI) syndrome

Cited by 20 publications

References 76 publications

The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study

The Management between Comorbidities and Pain Level with Physical Activity in Individuals with Hip Osteoarthritis with Surgical Indication: A Cross-Sectional Study

Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures

Open MRI validation of a hip model driven with subject-specific motion capture data in predicting anterior femoroacetabular clearance

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