Prevalence of Femoroacetabular Impingement Imaging Findings in Asymptomatic Volunteers: A Systematic Review

Frank, Jonathan M.; Harris, Joshua D.; Erickson, Brandon J.; Slikker, William; Bush‐Joseph, Charles A.; Salata, Michael J.; Nho, Shane J.

doi:10.1016/j.arthro.2014.11.042

Cited by 389 publications

(309 citation statements)

References 43 publications

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“…The cam type generally involves an FHN deformity and the pincer-type acetabular overcoverage [1]. There is a wide discrepancy in reported prevalence rates between cam and pincer FAI among asymptomatic and symptomatic and athletes [5,6].…”

Section: Introductionmentioning

confidence: 99%

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

et al. 2016

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Objective Our objectives were to use 3D computed tomography (CT) to define head-neck morphologic gender-specific and normative parameters in asymptomatic individuals and use the omega angle (Ω°) to provide quantification data on the location and radial extension of a cam deformity. Methods We prospectively included 350 individuals and evaluated 188 asymptomatic hips that underwent semiautomated CT analysis. Different thresholds of alpha angle (α°) were considered in order to analyze cam morphology and determine Ω°. We calculated overall and gender-specific parameters for imaging signs of cam morphology (Ω°and circumferential α°). Results The 95 % reference interval limits were beyond abnormal thresholds found in the literature for cam morphology. Specifically, α°at 3/1 o´clock were 46.9°/60.8°overall, 51.8°/ 65.4°for men and 45.7°/55.3°for women. Cam prevalence, magnitude, location, and epicenter were significantly gender different. Increasing α°correlated with higher Ω°, meaning that higher angles correspond to larger cam deformities.Conclusion Hip morphometry measurements in this cohort of asymptomatic individuals extended beyond current thresholds used for the clinical diagnosis of cam deformity, and α°was found to vary both by gender and measurement location. These results suggest that α°measurement is insufficient for the diagnosis of cam deformity. Enhanced morphometric evaluation, including 3D imaging and Ω°, may enable a more accurate diagnosis. Key Points • 95% reference interval limits of cam morphotype were beyond currently defined thresholds.• Current morphometric definitions for cam-type morphotype should be applied with care.• Cam prevalence, magnitude, location, and epicenter are significantly gender different.• Cam and alpha angle thresholds should be defined according to sex/location. • Quantitative 3D morphometric assessment allows thorough and reproducible FAI diagnosis and monitoring.

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Section: Introductionmentioning

confidence: 99%

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

et al. 2016

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“…A study of 1076 people with symptomatic FAI undergoing surgery, reported a prevalence of cam FAI of 47.6%, combined FAI of 44.5%, and pincer FAI of 7.9% [8]. The less common pincer-type typically presents in an older demographic (30-40 years) [9] and likely associates with unique biomechanical strategies in the absence of a bony deformity of the femoral head.…”

Section: Introductionmentioning

confidence: 99%

Hip joint biomechanics during gait in people with and without symptomatic femoroacetabular impingement

et al. 2016

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Highlights Symptomatic FAI is associated with minimal impairments in gait biomechanics. Individuals with symptomatic FAI demonstrate decreased sagittal plane hip ROM. The magnitude of the gait changes are small and of unknown clinical relevance. Gait assessment/training is unlikely to be beneficial in symptomatic FAI. and kinetics were compared between the two groups. There were limited significant betweengroup differences with respect to spatiotemporal variables. Participants with FAI walked with less range of motion in the sagittal plane during a gait cycle, but did not exhibit any significant kinematic differences in the frontal or transverse planes. There were no systematic differences in kinetics between the groups in any plane. Findings suggest that individuals with symptomatic FAI have minimal impairments in gait biomechanics. Although these individuals demonstrate reduced hip joint motion in the sagittal plane, the size of the difference is small and its significance for symptoms and function is unclear. More pronounced deficits in hip kinetics and kinematics may be evident during functional tasks that challenge the hip towards the position of impingement.

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“…In addition to normal reference values, we need reference-range values both for acetabular overcoverage and undercoverage. However, abnormal acetabular morphology is common among asymptomatic subjects [3,4,7,8], so we will depend on future studies to compare differences in acetabular morphology between asymptomatic and symptomatic hips. Only after ascertaining normal ranges, normal variants, and pathologic variations, would both the AWI and PWI be incorporated as a diagnosis and intraoperative aid tool.…”

Section: Where Do We Need To Go?mentioning

confidence: 99%

CORR Insights®: Acetabular Wall Indices Help to Distinguish Acetabular Coverage in Asymptomatic Adults with Varying Morphologies

Piuzzi

2017

Clinical Orthopaedics &Amp; Related Research

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Prevalence of Femoroacetabular Impingement Imaging Findings in Asymptomatic Volunteers: A Systematic Review

Cited by 389 publications

References 43 publications

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

Cam deformity and the omega angle, a novel quantitative measurement of femoral head-neck morphology: a 3D CT gender analysis in asymptomatic subjects

Hip joint biomechanics during gait in people with and without symptomatic femoroacetabular impingement

CORR Insights®: Acetabular Wall Indices Help to Distinguish Acetabular Coverage in Asymptomatic Adults with Varying Morphologies

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