The envelope of active hip motion in different sporting, recreational, and daily-living activities: A systematic review

Han, Shuyang; Kim, Ryan S.; Harris, Joshua D.; Noble, Philip C.

doi:10.1016/j.gaitpost.2019.05.006

Cited by 14 publications

(25 citation statements)

References 68 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 Specifically, 3 activities (sex, sitting cross-legged, and grand ecart lateral in ballet) require extreme simultaneous degrees of hip motion. 16…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Hip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion

et al. 2022

View full text Add to dashboard Cite

Background: Symptomatic patients with femoroacetabular impingement (FAI) have limitations in daily activities and sports and report the exacerbation of hip pain in deep flexion. Yet, the exact impingement location in deep flexion and the effect of femoral version (FV) are unclear. Purpose: To investigate the acetabular and femoral locations of intra- or extra-articular hip impingement in flexion in patients with FAI with and without femoral retroversion. Study Design: Cross-sectional study; Level of evidence, 3. Methods: An institutional review board–approved retrospective study involving 84 hips (68 participants) was performed. Of these, symptomatic patients (37 hips) with anterior FAI and femoral retroversion (FV <5°) were compared with symptomatic patients (21 hips) with anterior FAI (normal FV) and with a control group (26 asymptomatic hips without FAI and normal FV). All patients were symptomatic, had anterior hip pain, and had positive anterior impingement test findings. Most of the patients had hip/groin pain in maximal flexion or deep flexion or during sports. All 84 hips underwent pelvic computed tomography (CT) to measure FV as well as validated dynamic impingement simulation with patient-specific CT-based 3-dimensional models using the equidistant method. Results: In maximal hip flexion, femoral impingement was located anterior-inferior at 4 o’clock (57%) and 5 o’clock (32%) in patients with femoral retroversion and mostly at 5 o’clock in patients without femoral retroversion (69%) and in asymptomatic controls (76%). Acetabular intra-articular impingement was located anterior-superior (2 o’clock) in all 3 groups. In 125° of flexion, patients with femoral retroversion had a significantly ( P < .001) higher prevalence of anterior extra-articular subspine impingement (54%) and anterior intra-articular impingement (89%) compared with the control group (29% and 62%, respectively). Conclusion: Knowing the exact location of hip impingement in deep flexion has implications for surgical treatment, sports, and physical therapy and confirms previous recommendations: Deep flexion (eg, during squats/lunges) should be avoided in patients with FAI and even more in patients with femoral retroversion. Patients with femoral retroversion may benefit and have less pain when avoiding deep flexion. For these patients, the femoral location of the impingement conflict in flexion was different (anterior-inferior) and distal to the cam deformity compared with the location during the anterior impingement test (anterior-superior). This could be important for preoperative planning and bone resection (cam resection or acetabular rim trimming) during hip arthroscopy or open hip preservation surgery to ensure that the region of impingement is appropriately identified before treatment.

show abstract

“…16 Specifically, 3 activities (sex, sitting cross-legged, and grand ecart lateral in ballet) require extreme simultaneous degrees of hip motion. 16…”

Section: Discussionmentioning

confidence: 99%

“…This is in accordance with a recent systematic review that summarized that supraphysiological hip motion is required for many activities. 16 Specifically, 3 activities (sex, sitting cross-legged, and grand ecart lateral in ballet) require extreme simultaneous degrees of hip motion. 16 This study has limitations.…”

Section: Discussionmentioning

confidence: 99%

Hip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion

et al. 2022

View full text Add to dashboard Cite

show abstract

“…Sample videos are provided for sit-to-stand motion without implant impingement (Supplementary Video 1; http://links.lww.com/CORR/A721) and with implant impingement (Supplementary Video 2; http:// links.lww.com/CORR/A722). Because there is no agreement regarding hip ROM during different activities of daily living [5,16,20,34,53,55], we chose an average hip ROM value and sagittal pelvic tilt with 6 30°for the simulation based on the reported range [8,17,24,39,40,49] (Table 1). The anatomic acetabular implant orientation was 40°for abduction and 20°for anteversion.…”

Section: Model Without Random Variationmentioning

confidence: 99%

Small Random Angular Variations in Pelvic Tilt and Lower Extremity Can Cause Error in Static Image-based Preoperative Hip Arthroplasty Planning: A Computer Modeling Study

Pour

Lazennec

Patel

et al. 2022

Clin Orthop Relat Res

View full text Add to dashboard Cite

BackgroundMany THA simulation models rely on a limited set of preoperative static radiographs to replicate sagittal pelvic tilt during functional positions and to recommend an implant orientation that minimizes the risk of prosthetic impingement. However, possible random changes in pelvic or lower extremity angular motions and the effect of coronal and axial pelvic tilt are not included in these preoperative models.Questions/purposes(1) Can prosthetic impingement occur if the pelvic tilt or lower extremity alignment randomly varies up to ± 5° from what is measured on a single preoperative static radiographic image? (2) Do changes in coronal and axial pelvic tilt or lower extremity alignment angles have a similar effect on the risk of prosthetic impingement?MethodsA de-identified pelvis and lower-body CT image of a male patient without previous THA or lower extremity surgery was used to import the pelvis, femur, and tibia into a verified MATLAB computer model. The motions of standing, pivoting, sitting, sit-to-stand, squatting, and bending forward were simulated. THA implant components included a full hemispherical acetabular cup without an elevated rim, polyethylene liner without an elevated rim, femoral head (diameter: 28 mm, 32 mm, 36 mm, or 40 mm), and a triple-taper cementless stem with three different neck shaft angles (127°, 132°, or 135°) with a trapezoidal neck were used in this model. A static model (cup anatomical abduction 40°, cup anatomical anteversion 20°, stem anatomical anteversion 10°) with a predefined range of sagittal pelvic tilt and hip alignment (0° coronal or axial tilt, without random ± 5° change) was used to simulate each motion. We then randomly varied pelvic tilt in three different pelvic planes and hip alignments (flexion, extension, abduction, adduction, rotation) up to ± 5° and assessed the same motions without changing the implant’s anatomical orientation. Prosthetic impingement as the endpoint was defined as mechanical abutment between the prosthetic neck and polyethylene liner. Multiple logistic regression was used to investigate the effect of variation in pelvic tilt and hip alignment (predictors) on prosthetic impingement (primary outcome).ResultsThe static-based model without the random variation did not result in any prosthetic impingement under any conditions. However, with up to ± 5° of random variation in the pelvic tilt and hip alignment angles, prosthetic impingement occurred in pivoting (18 possible combinations), sit-to-stand (106 possible combinations), and squatting (one possible combination) when a 28-mm or a 32-mm head was used. Variation in sagittal tilt (odds ratio 4.09 [95% CI 3.11 to 5.37]; p < 0.001), axial tilt (OR 3.87 [95% CI 2.96 to 5.07]; p < 0.001), and coronal tilt (OR 2.39 [95% CI 2.03 to 2.83]; p < 0.001) affected the risk of prosthetic impingement. Variation in hip flexion had a strong impact on the risk of prosthetic impingement (OR 4.11 [95% CI 3.38 to 4.99]; p < 0.001).ConclusionThe combined effect of 2° to 3° of change in multiple pelvic ti...

show abstract

“…It has been assumed that correcting range of motion (ROM) limiting morphological abnormalities (impingement, dysplasia, version, ligament, and muscular tightness) would allow resumption of athletic activity, however, impingement characteristics and the specific requirements of joint motion vary greatly across different sports. In ballet dancers, it has been reported that impingement and degenerative change is likely to occur through supra-physiological range ROM, rather than aberrant bony morphology, although ROM limiting factors have been suggested to further vary between dancers [ 32 ].…”

Section: Introductionmentioning

confidence: 99%

Understanding hip pathology in ballet dancers

Singh

Pettit

et al. 2022

Knee Surg Sports Traumatol Arthrosc

View full text Add to dashboard Cite

Purpose The literature on hip injuries in ballet dancers was systematically evaluated to answer (1) whether the prevalence of morphological abnormalities and pathology of hip injuries in dancers differs from the general population (2) if there are any specific risk factors which contribute to a higher rate of hip injury and (3) what are the outcomes of primary and secondary intervention strategies. Methods A systematic literature search of Medline, EMBASE and the Cochrane Library was undertaken for all literature relating to hip injuries in ballet dancers using the PRISMA guidelines. Reference lists were also searched for relevant literature. Clinical outcome studies, prospective/retrospective case series published between 1989 and October 2021 were included. Review articles (non-original data), case reports, studies on animals as well as book chapters were excluded. Results The search yielded 445 studies, of which 35 were included for final analyses after screening. This included 1655 participants, of which 1131 were females. The analyses revealed that damage at the chondrolabral junction and degenerative disease of the hip may develop at a higher rate in ballet dancers than in the general population (odds ratio > 1 in 15/18 cohorts). The intra-articular lesions were more frequently found in postero-superior region of the hip suggesting an alternative impingement mechanism. Furthermore, numerous risk factors specific for hip injury in ballet were highlighted amidst a wide body of literature which consistently reports risk factors for a more generic ‘dancer vulnerability’. Conclusion Ballet dancers may suffer from both higher rates of chondrolabral damage and degenerative disease in their hips. In contrast to other sports, the intra-articular lesions are more frequently found in postero-superior region of the hip. Future research clarifying the prevalence of osseous abnormalities and prevention strategies in dancers may be pivotal in delaying the development of hip disease in this cohort. Level of evidence Level IV.

show abstract

The envelope of active hip motion in different sporting, recreational, and daily-living activities: A systematic review

Cited by 14 publications

References 68 publications

Hip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion

Hip Impingement Location in Maximal Hip Flexion in Patients With Femoroacetabular Impingement With and Without Femoral Retroversion

Small Random Angular Variations in Pelvic Tilt and Lower Extremity Can Cause Error in Static Image-based Preoperative Hip Arthroplasty Planning: A Computer Modeling Study

Understanding hip pathology in ballet dancers

Contact Info

Product

Resources

About