Influence of evolution on cam deformity and its impact on biomechanics of the human hip joint

Anwander, Helen; Beck, Martín; Büchler, Lorenz

doi:10.1002/jor.23863

Cited by 10 publications

(6 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The original SDS study showed that the sphericity deviation score values for Stulberg Class-I and II hips were significantly lower and distinctly different from all other Stulberg classes ( P <0.001). To evaluate the clinical relevance of the modified method for SDS measurements, we investigated its correlation with the Stulberg classification and hip ROM as the Stulberg classification is strongly associated with the long-term outcome of patients with LCPD, 3 and reduced hip ROM is an indicator of femoral head asphericity 8 . A progressive loss of hip ROM is also known to be associated with poor prognosis 9 .…”

Section: Discussionmentioning

confidence: 99%

Reliability of the Modified Method for Sphericity Deviation Score Using Only the Involved Hip Radiographs in the Patients With Legg-Calve-Perthes Disease

Kang

Kak

Prasadh

et al. 2023

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

Background: The sphericity deviation score (SDS) is a validated radiographic outcome measure that quantifies the severity of the femoral head deformity in the healed stage of Legg-Calve-Perthes disease (LCPD). The current method requires radiographs of both hips regardless of unilateral involvement to standardize radiographic magnification. As LCPD affects the unilateral hip in 85% to 90% of cases, the current method imposes unnecessary radiation exposure to most of the patients and having to exclude patients from research studies who only had unilateral hip radiographs. We thus modified the SDS method to use unilateral hip radiographs. The purpose of this study was to investigate the reliability of the modified SDS method using the radiographs containing only one hip. Methods: This retrospective study involved 40 patients with LCPD with unilateral involvement in the healed stage of LCPD. We modified the SDS measurement method by using the distance between the teardrop and the lateral acetabulum for magnification correction and providing a clear anatomic description of reference points on the femoral head. Three independent observers performed measurements using radiographs containing the affected hip only (modified method) and both hips (conventional method). The intraclass correlation (ICC) estimates were calculated. To verify clinical relevance, the correlation of the SDS with the Stulberg classification and hip range of motion (ROM) were also investigated. Results: Measurements using the modified SDS showed excellent inter-/intra-observer ICCs (0.903 to 0.978). The ICCs between the modified and conventional methods were also excellent: 0.940 to 0.966 within the same observer and 0.897 to 0.919 between different observers. The modified SDS showed moderate-to-strong correlations with the Stulberg classification (Spearman ρ=0.650) and hip ROM (Pearson r=−0.661). Conclusion: The modified SDS measurement method showed excellent inter-/intra-observer reliability and moderate-to-strong correlations with the Stulberg classification and hip ROM. This method will help reduce unnecessary radiation exposure in patients with unilateral LCPD and prevent the exclusion of patients with unilateral radiographs from future research studies. Level of Evidence: Level III—diagnostic study.

show abstract

Section: Discussionmentioning

confidence: 99%

Reliability of the Modified Method for Sphericity Deviation Score Using Only the Involved Hip Radiographs in the Patients With Legg-Calve-Perthes Disease

Kang

Kak

Prasadh

et al. 2023

Journal of Pediatric Orthopaedics

View full text Add to dashboard Cite

show abstract

“…It must be noted that ROM improvement is not a true target of FAI treatment and does not directly link to the resolution of FAI conditions, because the substantial mechanism of FAI is shear stress at cartilage during engagements of acetabulum and cam morphology. 1 Nevertheless, ROM until occurring bony impingement is an approachable parameter of the FAI condition.…”

Section: Discussionmentioning

confidence: 99%

Effect of Decreasing the Anterior Pelvic Tilt on Range of Motion in Femoroacetabular Impingement: A Computer-Simulation Study

Kobayashi

Higashihira

Kitayama

et al. 2021

Orthopaedic Journal of Sports Medicine

View full text Add to dashboard Cite

Background: The influence of pelvic tilt mobility, which can be reproduced in computer-simulation models, is an important subject to be addressed in the understanding of femoroacetabular impingement (FAI) pathophysiology. Purpose: To use computer-simulation models of FAI cases to evaluate the optimum improvement in hip range of motion (ROM) achieved by decreasing the anterior pelvic tilt and compare the results with the improvement in ROM achieved after cam resection surgery. Study Design: Controlled laboratory study. Methods: The pre- and postoperative computed tomography (CT) images from 28 patients with FAI treated with arthroscopic cam resection were evaluated. Using a dynamic computer-simulation program, 3-dimensional models with a 5° and a 10° decrease in anterior pelvic tilt from the supine functional pelvic plane (baseline) were created from the preoperative CT scans. Similar models were constructed for hips before (at baseline) and after cam resection. Improvements from baseline in maximum internal rotation at 45°, 70°, and 90° of flexion were assessed for the 5° change in pelvic tilt, 10° change in pelvic tilt, and cam resection models, and the results were compared for all conditions. Results: The combination of a 10° change in pelvic tilt and cam resection showed the largest ROM improvement from baseline ( P < .001). Improvement in internal rotation in the cam resection model was significantly higher compared with the 5° pelvic tilt change model ( P < .001), while there was no significant difference between the cam resection model and the 10° pelvic tilt change model. Conclusion: Decreasing anterior pelvic tilt by 10° in the preoperative computer simulation model resulted in an equivalent effect to cam resection, while a 5° change in pelvic tilt was inferior to cam resection in terms of ROM improvement. Clinical Relevance: Enough of a decrease in anterior pelvic tilt may contribute to ROM improvement that is as effective as that of cam resection surgery.

show abstract

“… 1 - 6 This has been facilitated by the introduction of open and arthroscopic procedures to the native hip and the advancements in engineering and basic sciences. Although a clear association between abnormal mechanics and osteoarthritis (OA) development exists, 7 there is little doubt that genetic predisposition is important 8 , 9 and that the biological cascade leading to OA is not clearly understood or defined. 10 , 11 …”

Section: Introductionmentioning

confidence: 99%

Hip preservation surgery and the acetabular fossa

Slullitel

Coutu

Buttaro

et al. 2020

Bone & Joint Research

View full text Add to dashboard Cite

As our understanding of hip function and disease improves, it is evident that the acetabular fossa has received little attention, despite it comprising over half of the acetabulum’s surface area and showing the first signs of degeneration. The fossa’s function is expected to be more than augmenting static stability with the ligamentum teres and being a templating landmark in arthroplasty. Indeed, the fossa, which is almost mature at 16 weeks of intrauterine development, plays a key role in hip development, enabling its nutrition through vascularization and synovial fluid, as well as the influx of chondrogenic stem/progenitor cells that build articular cartilage. The pulvinar, a fibrofatty tissue in the fossa, has the same developmental origin as the synovium and articular cartilage and is a biologically active area. Its unique anatomy allows for homogeneous distribution of the axial loads into the joint. It is composed of intra-articular adipose tissue (IAAT), which has adipocytes, fibroblasts, leucocytes, and abundant mast cells, which participate in the inflammatory cascade after an insult to the joint. Hence, the fossa and pulvinar should be considered in decision-making and surgical outcomes in hip preservation surgery, not only for their size, shape, and extent, but also for their biological capacity as a source of cytokines, immune cells, and chondrogenic stem cells. Cite this article: Bone Joint Res 2020;9(12):857–869.

show abstract

Influence of evolution on cam deformity and its impact on biomechanics of the human hip joint

Cited by 10 publications

References 54 publications

Reliability of the Modified Method for Sphericity Deviation Score Using Only the Involved Hip Radiographs in the Patients With Legg-Calve-Perthes Disease

Reliability of the Modified Method for Sphericity Deviation Score Using Only the Involved Hip Radiographs in the Patients With Legg-Calve-Perthes Disease

Effect of Decreasing the Anterior Pelvic Tilt on Range of Motion in Femoroacetabular Impingement: A Computer-Simulation Study

Hip preservation surgery and the acetabular fossa

Contact Info

Product

Resources

About