Extra-Articular Impingement at the Anterior Inferior Iliac Spine: A Cause of Refractory Periarticular Pain After Total Hip Arthroplasty

Luyckx, Lucas; Hendrickx, Jens; Timmermans, Annick; Vandenabeele, Frank; Corten, Kristoff

doi:10.1016/j.artd.2020.07.016

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…The proposed 2-stage procedure can be a solution to this problem because none of the stems were malaligned, and all showed normal radiographic signs of ingrowth. Furthermore, the prominent overhanging GT might be a cause of postoperative extra-articular impingement, which could be a risk factor for dislocation or refractive groin pain [4]. In addition, a regular stem needs a good seating at the level of the calcar in order to reliably obtain good ingrowth.…”

Section: Discussionmentioning

confidence: 99%

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Relative Femoral Neck Lengthening in Legg-Calvé-Perthes Total Hip Arthroplasty

et al. 2022

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Section: Discussionmentioning

confidence: 99%

“…Overgrowth of the GT decreases the abductor lever arm and can lead to extra-articular impingement [4]. Insufficient functioning of the hip abductors is associated with aberrant joint loading and poor function [5].…”

Section: Introductionmentioning

confidence: 99%

Relative Femoral Neck Lengthening in Legg-Calvé-Perthes Total Hip Arthroplasty

et al. 2022

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Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Kobayashi

Kamono

Yamamoto

et al. 2022

Orthopaedic Journal of Sports Medicine

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Background: Subspine impingement, or anterior inferior iliac spine (AIIS) impingement, is a type of extra-articular pathology associated with femoroacetabular impingement syndrome and often requires subsequent arthroscopic surgery. Purpose: To examine the diagnostic accuracy, prevalence, and clinical outcomes of arthroscopic treatment for AIIS impingement. Study Design: Systematic review; Level of evidence, 4. Methods: The PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) 2020 checklist was applied. We searched for studies on the prevalence, diagnostic accuracy, and results of surgical treatment for AIIS impingement. For each included study, data synthesis and statistical analysis were performed to identify pooled prevalence, calculate clinical outcome scores, and estimate adverse events. The QUADAS (a quality assessment tool for diagnostic accuracy studies) was used to assess the quality of the diagnostic accuracy studies, and the Risk of Bias Assessment tool for Nonrandomized Studies was used to assess the quality of the studies on arthroscopic treatment efficacy. Results: Out of an initial 791 studies, 23 were included. AIIS impingement was diagnosed by plain radiography with 76% to 86% sensitivity, 3-dimensional computed tomography with 80% to 81.8% sensitivity, magnetic resonance imaging with 80% sensitivity, and ultrasound with 92.5% sensitivity. For patients who underwent hip arthroscopy, the pooled prevalence of AIIS impingement was 18%. Significant improvement between pre- and postoperative clinical outcomes was observed: 25.75 points for the modified Harris hip score (mHHS), 46.88 points for the Hip Outcome Score–Sport subscale, 20.85 points for the Nonarthritic Hip Score, and -2.92 points for the pain visual analog scale. The minimal clinically important difference on the mHHS was exceeded by 94% of patients. The pooled incidence of surgical complications was 1%. Of 6 included studies on diagnostic accuracy, 2 were identified as having a low risk of bias, and 4 included >2 factors with a high risk of bias. All 9 included studies on treatment outcomes had at least 1 factor with a high risk of bias. Conclusion: Several imaging modalities assist in the diagnosis of AIIS impingement. The overall prevalence of AIIS impingement in patients that underwent hip arthroscopy was 18%. Clinical outcomes after arthroscopic AIIS decompression were generally favorable, with a relatively low rate of surgical complications.

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Offset Considerations in Total Hip Arthroplasty

Driesman,

Jennings,

Yang

et al. 2024

J Am Acad Orthop Surg

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To perform total hip arthroplasty (THA) successfully, a surgeon must be able to place the implants in a position that will restore and duplicate the patient's baseline anatomy and soft-tissue tension. One of the critical factors is the restoration of femoral offset. It is the goal of this review to precisely define measurement of offset in THA, describe its role in hip joint biomechanics, outline alterations that can be performed intraoperatively, and explain how it can create potential pathologic states. If there is a lack of offset restoration, it can result in a host of complications, including bony impingement with pain, edge loading or prosthetic joint instability, and alterations in the muscle length-tension relationship leading to reduced motor performance. Excessive femoral offset can increase hip abductor muscle and iliotibial band tension resulting in greater trochanteric pain regardless of the surgical approach. The purpose of this review was to analyze intraoperative surgical factors, choice of prosthetic implant type and position that are required to maximize stability, and dynamic motor performance after THA.

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Extra-Articular Impingement at the Anterior Inferior Iliac Spine: A Cause of Refractory Periarticular Pain After Total Hip Arthroplasty

Cited by 3 publications

References 15 publications

Relative Femoral Neck Lengthening in Legg-Calvé-Perthes Total Hip Arthroplasty

Relative Femoral Neck Lengthening in Legg-Calvé-Perthes Total Hip Arthroplasty

Imaging Diagnosis, Prevalence, and Clinical Outcomes of Arthroscopic Surgery for Anterior Inferior Iliac Spine Impingement: A Systematic Review and Meta-analysis

Offset Considerations in Total Hip Arthroplasty

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