Effect of posture and femoral neck osteochondroplasty on femur-acetabulum clearance in patients with cam-type femoroacetabular impingement.

Autor: Wilson DR; Department of Orthopaedics, Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada., Zhang H; Department of Orthopaedics, Centre for Hip Health and Mobility, The University of British Columbia, Vancouver, British Columbia, Canada., Jones CE; Centre for Hip Health and Mobility, School of Biomedical Engineering, The University of British Columbia, Vancouver, British Columbia, Canada., Gilbart MK; Department of Orthopaedics, The University of British Columbia, Vancouver, British Columbia, Canada., Masri BA; Department of Orthopaedics, The University of British Columbia, Vancouver, British Columbia, Canada.
Jazyk: angličtina
Zdroj: Journal of orthopaedic research : official publication of the Orthopaedic Research Society [J Orthop Res] 2022 Feb; Vol. 40 (2), pp. 370-379. Date of Electronic Publication: 2021 Apr 06.
DOI: 10.1002/jor.25037
Abstrakt: It is not clear whether femoral neck osteochondroplasty achieves its objective of increasing femoroacetabular clearance. We used an upright open magnetic resonance imaging scanner to image the hip joint in multiple postures to explore the effect of posture and femoral neck osteochondroplasty on femur-acetabulum clearance in patients with cam-type femoroacetabular impingement. We recruited 13 consecutive patients scheduled to undergo arthroscopic femoral neck osteochondroplasty and completed assessments on 10 patients. We scanned each subject before surgery and at 6 months post-op in supine and 3 other physiological postures: supine 90° flexion with adduction and internal rotation (FADIR), sitting deep (maximal flexion with internal rotation and adduction), and sitting crossed leg (maximal adduction with flexion and internal rotation). We measured the alpha angle, which describes the severity of cam deformity, and the beta angle, which defines joint clearance. We also evaluated hip flexion, internal rotation, and adduction before and after surgery. Femoral neck osteochondroplasty significantly decreased alpha angle by 23.9° ± 4.6° (p = 0.001) and increased beta angle across all postures by 28.1° ± 6.3° (p = 0.002). An increase in beta angle represented a decreased chance of impingement. Femoral neck osteochondroplasty significantly increased flexion by an average of 8.6° in the sitting deep posture after surgery (p = 0.007) which might indicate an improvement of joint function. These findings lend support to the hypothesis that arthroscopic osteochondroplasty accomplishes its stated goals of increasing bone-bone clearance in the hip joint and improving joint mechanics for the static postures assessed.
(© 2021 Orthopaedic Research Society. Published by Wiley Periodicals LLC.)
Databáze: MEDLINE
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