Limited External Rotation and Hip Extension Due to Posterior Extra-articular Ischiofemoral Hip Impingement in Female Patients With Increased Femoral Anteversion: Implications for Sports, Sexual, and Daily Activities

Autor: Boschung, Adam, Antioco, Tiziano, Steppacher, Simon D, Tannast, Moritz, Novais, Eduardo N, Kim, Young-Jo, Lerch, Till Dominic
Rok vydání: 2023
Předmět:
Zdroj: The American Journal of Sports Medicine. 51:1015-1023
ISSN: 1552-3365
0363-5465
Popis: Background: Posterior femoroacetabular impingement (FAI) is poorly understood. Patients with increased femoral anteversion (FV) exhibit posterior hip pain. Purpose: To correlate hip impingement area with FV and with combined version and to investigate frequency of limited external rotation (ER) and hip extension (Study Design: Cross-sectional study; Level of evidence, 3. Methods: Osseous patient-specific three-dimensional (3D) models based on 3D computed tomography scans were generated of 37 female patients (50 hips) with positive posterior impingement test (100%) and increased FV >35° (Murphy method). Surgery was performed in 50% of patients (mean age, 30 years; 100% female). FV and acetabular version (AV) were added to calculate combined version. Subgroups of patients (24 hips) with increased combined version >70° and patients (9 valgus hips) with increased combined version >50° were analyzed. The control group (20 hips) had normal FV, normal AV, and no valgus. Bone segmentation was performed to generate 3D models of every patient. Validated 3D collision detection software was used for simulation of impingement-free hip motion (equidistant method). Impingement area was evaluated in combined 20° of ER and 20° of extension. Results: Posterior extra-articular ischiofemoral impingement occurred between the ischium and the lesser trochanter in 92% of patients with FV >35° in combined 20° of ER and 20° of extension. Impingement area in combined 20° of ER and 20° of extension was larger with increasing FV and with higher combined version; correlation was significant ( P < .001, r = 0.57, and r = 0.65). Impingement area was significantly ( P = .001) larger (681 vs 296 mm2) for patients with combined version >70° (vs 35° (100%) had limited ER 35° with limited extension 50° compared with patients with FV >35° (0%). Conclusion: All patients with increased FV >35° had limited ER
Databáze: OpenAIRE
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