The Bipolar Hip: How Acetabular and Femoral Pathomorphology Affects Hip Motion in Femoral Acetabular Impingement Syndrome

Shin, Jessica; Adeyemi, Temitope F; Hobson, Taylor; Peters, Christopher L.; Maak, Travis G.

doi:10.1016/j.arthro.2020.02.044

Cited by 17 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We have previously shown the CT-based midcoronal CEA to over-represent radiographic LCEA measurements by an average of 5.5 (range, 3.7 -7.3 ) in patients with dysplasia and cam-type FAI. 2 The midcoronal CEA in the present cohort ranged from 17 to 53 (Table 1 of Shin et al 8 ), indicating that patients with severe dysplasia were included and combined with the rest of the cohort for analysis. Combining patients with dysplasia with the rest of the cohort poses a particular problem for the relation between acetabular version and hip internal rotation.…”

Section: See Related Article On Page 1864mentioning

confidence: 95%

“…10 We suggest the "combined femoral torsion and acetabular version (COTAV) index" to be a more apt term to describe the modern CT-based measurement of combined version. 8 In addition, the reported clinical range of motion in the present study did not include internal and external rotation at neutral hip flexion, which is typically obtained during a prone examination. This is important because when the hip is in neutral flexion, the effect of cam impingement on internal rotation is effectively eliminated, revealing the true underlying association between the COTAV index and clinical range of motion.…”

Section: See Related Article On Page 1864mentioning

confidence: 97%

“…Furthermore, CT-based hip-mapping software has allowed us to delineate the precise area of bony conflict for both the femur and acetabulum, enabling more accurate and complete bony resection. 7 The study by Shin et al 8 adds to this growing body of knowledge by reporting on the correlation between CT-based morphologic features and clinical range of motion in FAI patients.…”

Section: See Related Article On Page 1864mentioning

confidence: 99%

“…Shin et al 8 use the "McKibbin index," which is an antiquated term defined by the summation of femoral and acetabular version based on gross specimen examination in a cadaveric cohort of 15 full-term infants. 10 We suggest the "combined femoral torsion and acetabular version (COTAV) index" to be a more apt term to describe the modern CT-based measurement of combined version.…”

Section: See Related Article On Page 1864mentioning

confidence: 99%

“…We praise Shin et al 8 for their thoughtful discussion, which raises several key considerations. At present, CT scans are performed in the supine position and therefore do not capture the dynamic effect of weight bearing on pelvic tilt, which can result in a significant change in acetabular version.…”

Section: See Related Article On Page 1864mentioning

confidence: 99%

See 4 more Smart Citations

Editorial Commentary: Treating Hip Impingement Without a Computed Tomography Scan? You Might as Well Operate With a Blindfold

Garabekyan¹,

Mei-Dan

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

Hip impingement is defined as a bony conflict between the femur and acetabulum occurring throughout normal or supraphysiological range of motion. Traditionally, the cause was attributed to reduced femoral head-neck offset and/or excessive acetabular coverage, giving rise to cam, pincer, and mixed impingement. However, recent outcome studies showing less favorable results of hip arthroscopy in patients with femoral and acetabular version abnormalities have sparked renewed interest in the pathomechanics of hip impingement. We now have a greater appreciation for the 3dimensional scope of the problem through specialized computed tomography sequencing allowing assessment of the entire limb and pelvis. Consequently, we have learned that rotational hip range of motion is more strongly correlated with combined femoral and acetabular version than with the sphericity of the femoral head, allowing us to counsel patients accordingly. We also recognize that impingement can occur with little to no femoral asphericity if the combined femoral and acetabular version does not permit adequate clearance for unimpeded motion. This improved understanding can be applied to diagnose subtle and uncommon cases of impingement and will ultimately enable a more complete bony resection.

show abstract

Section: See Related Article On Page 1864mentioning

confidence: 95%

Section: See Related Article On Page 1864mentioning

confidence: 97%

Section: See Related Article On Page 1864mentioning

confidence: 99%

Section: See Related Article On Page 1864mentioning

confidence: 99%

Section: See Related Article On Page 1864mentioning

confidence: 99%

See 3 more Smart Citations

Editorial Commentary: Treating Hip Impingement Without a Computed Tomography Scan? You Might as Well Operate With a Blindfold

Garabekyan¹,

Mei-Dan

2020

Arthroscopy: The Journal of Arthroscopic & Related Surgery

View full text Add to dashboard Cite

show abstract

Combined femoral and acetabular version and synovitis are associated with dGEMRIC scores in people with femoroacetabular impingement (FAI) syndrome

Murphy

Eyles

Spiers

et al. 2023

Journal Orthopaedic Research

View full text Add to dashboard Cite

This study sought to explore, in people with symptoms, signs and imaging findings of femoroacetabular impingement (FAI syndrome): (1) whether more severe labral damage, synovitis, bone marrow lesions, or subchondral cysts assessed on magnetic resonance imaging (MRI) were associated with poorer cartilage health, and (2) whether abnormal femoral, acetabular, and/or combined femoral and acetabular versions were associated with poorer cartilage health. This cross‐sectional study used baseline data from the 50 participants with FAI syndrome in the Australian FASHIoN trial (ACTRN12615001177549) with available dGEMRIC scans. Cartilage health was measured using delayed gadolinium‐enhanced MRI of cartilage (dGEMRIC) score sampled at the chondrolabral junction on three midsagittal slices, at one acetabular and one femoral head region of interest on each slice, and MRI features were assessed using the Hip Osteoarthritis MRI Score. Analyses were adjusted for alpha angle and body mass index, which are known to affect dGEMRIC score. Linear regression assessed the relationship with the dGEMRIC score of (i) selected MRI features, and (ii) femoral, acetabular, and combined femoral and acetabular versions. Hips with more severe synovitis had worse dGEMRIC scores (partial η2 = 0.167, p = 0.020), whereas other MRI features were not associated. A lower combined femoral and acetabular version was associated with a better dGEMRIC score (partial η2 = 0.164, p = 0.021), whereas isolated measures of femoral and acetabular version were not associated. In conclusion, worse synovitis was associated with poorer cartilage health, suggesting synovium and cartilage may be linked to the pathogenesis of FAI syndrome. A lower combined femoral and acetabular version appears to be protective of cartilage health at the chondrolabral junction.

show abstract

Imaging of the Hip

Sutter

Blankenbaker

2021

IDKD Springer Series

View full text Add to dashboard Cite

Imaging evaluation of the hip joint requires expert knowledge about the detailed anatomy and specific injuries. This chapter will include various osseous pathologies that can affect the hip joint such as stress fractures, osteonecrosis, or subchondral insufficiency fractures. Several types of mechanical impingement between the osseous components of the hip joint will be discussed such as femoroacetabular impingement, abnormal antetorsion, and subspine impingement. Detailed evaluation of damage to the labrum, articular cartilage, and other intra-articular structures is described.

show abstract

The Bipolar Hip: How Acetabular and Femoral Pathomorphology Affects Hip Motion in Femoral Acetabular Impingement Syndrome

Cited by 17 publications

References 25 publications

Editorial Commentary: Treating Hip Impingement Without a Computed Tomography Scan? You Might as Well Operate With a Blindfold

Editorial Commentary: Treating Hip Impingement Without a Computed Tomography Scan? You Might as Well Operate With a Blindfold

Combined femoral and acetabular version and synovitis are associated with dGEMRIC scores in people with femoroacetabular impingement (FAI) syndrome

Imaging of the Hip

Contact Info

Product

Resources

About