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

Dudda, Marcel; Albers, Christoph E.; Mamisch, Tallal C.; Werlen, Stefan; Beck, Martín

doi:10.1007/s11999-008-0617-5

Cited by 173 publications

(169 citation statements)

References 27 publications

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“…Another limitation is a reliance on radiography as opposed to CT or MRI with radial reformation to determine the angle a. The impingement site at the anterolateral quadrant of the femoral head neck junction is commonly a blind zone radiographically [4]. Although this is true, the aim of the study was to define the normal angle a on the lateral crosstable view so the hip surgeon has a reliable value above which impingement is more likely to occur.…”

Section: Discussionmentioning

confidence: 99%

Impingement-free Hip Motion: The ‘Normal’ Angle Alpha after Osteochondroplasty

Neumann

Cui

Siebenrock

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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Femoroacetabular impingement is considered a cause of hip osteoarthrosis. In cam impingement, an aspherical head-neck junction is squeezed into the joint and causes acetabular cartilage damage. The anterior offset angle a, observed on a lateral crosstable radiograph, reflects the location where the femoral head becomes aspheric. Previous studies reported a mean angle a of 42°i n asymptomatic patients. Currently, it is believed an angle a of 50°to 55°is normal. The aim of this study was to identify that angle a which allows impingement-free motion. In 45 patients who underwent surgical treatment for femoroacetabular impingement, we measured the angle a preoperatively, immediately postoperatively, and 1 year postoperatively. All hips underwent femoral correction and, if necessary, acetabular correction. The correction was considered sufficient when, in 90°hip flexion, an internal rotation of 20°to 25°was possible. The angle a was corrected from a preoperative mean of 66°(range, 45°-79°) to 43°(range, 34°-60°) postoperatively. Because the acetabulum is corrected to normal first, the femoral correction is tested against a normal acetabulum. We therefore concluded an angle a of 43°achieved surgically and with impingement-free motion, represents the normal angle a, an angle lower than that currently considered sufficient.

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Section: Discussionmentioning

confidence: 99%

Impingement-free Hip Motion: The ‘Normal’ Angle Alpha after Osteochondroplasty

Neumann

Cui

Siebenrock

et al. 2009

Clinical Orthopaedics &Amp; Related Research

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“…The most common location of the cam lesion is anterosuperior, between 12 and 3 o'clock on the femoral neck [7,27,29], which contacts either the acetabular rim [3,4,10] or the base of the anterior inferior iliac spine [16]. Similarly, classic acetabular dysplasia involves lateral and anterior undercoverage, causing static overload on the anterior and superior rim in stance with resultant anterosuperior rim damage [15].…”

Section: Discussionmentioning

confidence: 99%

“…structural factors. In up to 1 . 3 of patients with FAI, the pathoanatomy causing the impingement can only be visualized on radial MRI sequences or three-dimensional (3-D) CT reconstructions [6,7,29]. For some patients, 3-D simulations of hip motion are also helpful for elucidating the probable cause of the labral damage [3,4,16].…”

Section: Introductionmentioning

confidence: 99%

Case Reports: Anteroinferior Acetabular Rim Damage Due to Femoroacetabular Impingement

Tibor¹,

Ganz

Leunig

2013

Clinical Orthopaedics &Amp; Related Research

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Background The most common location of labral tears and chondral damage in the hip is the anterosuperior region of the acetabulum, which is associated with pain in flexion and rotation. We describe a case series of patients with labral tears, ganglion formation, and chondromalacia isolated to the anteroinferior acetabulum. Clinically, patients had pain in extension and internal rotation. Case Descriptions Isolated anteroinferior labral hypertrophy and ganglion were first observed in a patient with coxa valga. We retrospectively reviewed clinical and radiographic records and identified nine hips in seven patients with isolated anteroinferior damage. One patient with bilateral valgus femoral head tilt after slipped capital femoral epiphysis (SCFE) had impingement of the anteromedial metaphysis on the acetabulum from 3 to 6 o'clock.

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“…The angle alpha is measured on axial oblique MR images parallel to the axis of the femoral neck or on a lateral cross-table view [4,5]. Dudda et al [3] and Pfirrmann et al [6] reported the AP view was not sufficient for diagnosis of a cam deformity. Cobb et al therefore did not assess the asphericity of the femoral head-neck junction (cam deformity) correctly.…”

Section: To the Editormentioning

confidence: 99%

“…Cobb et al therefore did not assess the asphericity of the femoral head-neck junction (cam deformity) correctly. A proper method would include analysis of three-dimensional CT data [1] or measurement of the maximal asphericity on MR images with radial orientation through the axis of the femoral neck [3,7].…”

Section: To the Editormentioning

confidence: 99%

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

Cited by 173 publications

References 27 publications

Impingement-free Hip Motion: The ‘Normal’ Angle Alpha after Osteochondroplasty

Impingement-free Hip Motion: The ‘Normal’ Angle Alpha after Osteochondroplasty

Case Reports: Anteroinferior Acetabular Rim Damage Due to Femoroacetabular Impingement

Letter to the Editor: Cams and Pincer Impingement Are Distinct, Not Mixed: The Acetabular Pathomorphology of Femoroacetabular Impingement

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