Morphological variations in hip joint anatomy are a possible mechanism for femoroacetabular impingement (FAI) which leads to hip osteoarthritis. Significant geometric variations of the acetabular rim exist between patients including variations in depths of the postereosuperior depression (PSD) and psoas valley (PV). Computed tomographic scans of 48 FAI patients were segmented to create three-dimensional bone reconstructions. A pelvic plane was established using bony landmarks at the inferior iliac spines and the pubis. Placing a sphere on the articular surface of each acetabulum, the center of rotation was found. A curve was drawn on the acetabular rim to extract equally spaced points (0.67mm) to maximize output for an accurate representation of the profile. The acetabular plane was fit to the points using the least-squares method and translated to the center of rotation. The rim points were converted to cylindrical coordinates in degrees along the acetabulum and depth with respect to the mean acetabular plane. The mean depth of the PSD and PV were 7.27mm (SD 1.99) and 4.65mm (SD 2.12), respectively. The affected FAI hip was the right hip in 25 patients and the left hip in 23 patients. Comparisons were made on a per-patient basis between the acetabulum with FAI and without, and FAI hips had an increased coverage of the femoral head by the acetabulum. The appearance of cam and/or pincer impingement was also noted. The novel method of quantification of morphometric variations in the acetabular rim will further aid in understanding the development of FAI.
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JBJS Essent Surg Tech
December 2024
Sports Medicine Center, Department of Orthopaedics, Massachusetts General Hospital, Mass General Brigham, Boston, Massachusetts.
Background: Whereas uncomplicated labral tears with preserved fibers can be effectively treated with use of labral repair techniques, complex tears and hypoplastic labra require labral reconstruction. Standard reconstruction techniques feature grafted tissue that is added to existing, deficient tissue or that is utilized to replace a hypoplastic labrum entirely. However, such approaches utilizing allografts or remote autografts are limited because they often necessitate extensive debridement of the existing labrum to prepare a site for graft implantation, an approach that can damage and devascularize the chondrolabral junction.
View Article and Find Full Text PDFBone Joint J
December 2024
Scottish Rite for Children, Dallas, Texas, USA.
Aims: There has been limited literature regarding outcomes of acetabular rim syndrome (ARS) with persistent acetabular os in the setting of acetabular dysplasia. The purpose of this study was to characterize a cohort of adolescent and young adult patients with ARS with persistent os and compare their radiological and clinical outcomes to patients with acetabular dysplasia without an os.
Methods: We reviewed a prospective database of patients undergoing periacetabular osteotomy (PAO) for symptomatic acetabular dysplasia between January 1999 and December 2021 to identify hips with preoperative os acetabuli, defined as a closed triradiate cartilage but persistence of a superolateral os acetabulum.
Orthop J Sports Med
November 2024
Department of Orthopaedic Surgery, Stanford University, Stanford, California, USA.
Background: Acetabular labral tear morphology or orientation may influence hip stability.
Hypothesis: A radial tear of the acetabular labrum would result in greater rotational and translational motion compared with a chondrolabral separation.
Study Design: Controlled laboratory study.
J Clin Orthop Trauma
November 2024
Department of Orthopaedics, Hayatabad Medical Complex, Peshawar, Pakistan.
Hip arthroscopy has emerged as the primary surgical intervention for Femoroacetabular Impingement Syndrome (FAIS), a common cause of hip pain in young adults, particularly athletes. This narrative review examines the long-term outcomes, complications, and debates surrounding arthroscopic management of FAIS. Key findings include sustained improvements in patient-reported outcomes, return to sport, and functional recovery, particularly in younger patients and those with cam-type FAIS.
View Article and Find Full Text PDFJ Orthop Sci
November 2024
Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, 207, Uehara, Nishihara, Okinawa, Japan.
Background: Patients with developmental dysplasia of the hip (DDH) undergo curved periacetabular osteotomy (CPO) to prevent progressive osteoarthritis. The acetabulum's morphology varies with in each DDH type. Therefore, developing a three-dimensional preoperative plan is important in CPO.
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