Increased Prevalence of Femoroacetabular Impingement in Patients With Proximal Hamstring Tendon Injuries

Editorial Commentary: A Simple Twist of Fate: The Ramifications of Abnormal Femoral Version

“…Kraeutler found that femoral retroversion had a greater effect upon hip internal rotation than a cam lesion. 20 I agree with that finding, noting a greater internal rotation improvement following derotation osteotomy than after an arthroscopic osteochondroplasty. Keep in mind that the acetabulum may also be retroverted or excessively anteverted, compounding or offsetting the femoral deformity.…”

“…While it is understandable that femoral retroversion or increased anteversion can cause labral and chondral damage, it is important to realize that a host of extraarticular problems can also occur. There are those that occur close to the hip joint such as posterior hip impingement, 21 ischiofemoral impingement (IFI), 22 abductor weakness, 23 Hamstring origin tendonopathy 20 and psoas tendonitis. 24 But there are also well documented problems that occur farther away from the hip joint, such as patellofemoral maltracking, 25 core muscle injury (athletic pubalgia) 26 and the spine problems due to hip motion restrictions.…”

Return to Sport After Proximal Hamstring Tendon Repair: A Systematic Review

“…4,10,11 Conditions such as femoroacetabular impingement may place a patient at an increased risk of proximal HT injuries by restricting hip range of motion and altering pelvic tilt. 14 HT repair involves the reattachment of a tendon that has been completely separated from the ischial tuberosity or the restoration of a partial tear that is usually characterized by partial detachment from the bone while maintaining considerable continuity with the ischial tuberosity. 16,27 Surgical treatment is recommended when at least 2 tendons are ruptured, tendon retraction is ≥2 cm, 1 or in high-level athletes with chronic pain related to partial tears that do not involve any retraction of the tendon.…”

Editorial Commentary: Proximal Hamstring Injuries—Is the Hip to Blame?

“…Patients suffering from chronic PHI tend to be participants of repetitive motion activities such as long-distance running and cycling. 25 Based on the findings presented in this study, 9 the anterior pelvic tilt compensation model may make sense as a contributing factor for chronic PHI patients who also have underlying FAI. Take, for example, the cycling athlete who spends hours on a road bike with the pelvis locked into an anterior tilted position.…”

“…17,18 Analogous to the shoulder with glenohumeral internal rotation deficiency, it is theorized that limited internal rotation of the impinging hip joint alters the forces and kinetic motion of adjacent joints and soft tissue structures of the hip and pelvis. PHI may be one more example of this phenomenon, and this potential relation is highlighted in the study by Kraeutler et al 9 The authors present their theory on what specific factors in the impinging hip may lead to PHI. Their first theory is predicated on the limited hip rotational mobility common in FAI.…”