Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures

Aims: Cam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-...

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Autores principales:	Maryam Mohtajeb, Jolanda Cibere, Michelle Mony, Honglin Zhang, Emily Sullivan, Michael A. Hunt, David R. Wilson
Formato:	article
Lenguaje:	EN
Publicado:	The British Editorial Society of Bone & Joint Surgery 2021
Materias:	hip femoroacetabular impingement biomechanics mri hips femoral head flexion femoroacetabular impingement syndrome adduction acetabular rim arthritic hip anterior impingement hip osteoarthritis (oa) Orthopedic surgery RD701-811
Acceso en línea:	https://doaj.org/article/4dc6e5c77ee548bd993ee05c1be799e3
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spelling	oai:doaj.org-article:4dc6e5c77ee548bd993ee05c1be799e32021-12-01T18:44:47ZOpen MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures2633-146210.1302/2633-1462.211.BJO-2021-0143https://doaj.org/article/4dc6e5c77ee548bd993ee05c1be799e32021-11-01T00:00:00Zhttps://online.boneandjoint.org.uk/doi/epdf/10.1302/2633-1462.211.BJO-2021-0143https://doaj.org/toc/2633-1462Aims: Cam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-neck contour and acetabular rim in positions of hip flexion combined with rotation is a proposed pathomechanism in these hips, but this has not been studied in active postures. Our aim was to assess the anterior impingement pathomechanism in both active and passive postures with high hip flexion that are thought to provoke impingement. Methods: We recruited nine participants with cam and/or pincer morphologies and with pain, 13 participants with cam and/or pincer morphologies and without pain, and 11 controls from a population-based cohort. We scanned hips in active squatting and passive sitting flexion, adduction, and internal rotation using open MRI and quantified anterior femoroacetabular clearance using the β angle. Results: In squatting, we found significantly decreased anterior femoroacetabular clearance in painful hips with cam and/or pincer morphologies (mean -11.3° (SD 19.2°)) compared to pain-free hips with cam and/or pincer morphologies (mean 8.5° (SD 14.6°); p = 0.022) and controls (mean 18.6° (SD 8.5°); p < 0.001). In sitting flexion, adduction, and internal rotation, we found significantly decreased anterior clearance in both painful (mean -15.2° (SD 15.3°); p = 0.002) and painfree hips (mean -4.7° (SD 13°); p = 0.010) with cam and/pincer morphologies compared to the controls (mean 7.1° (SD 5.9°)). Conclusion: Our results support the anterior femoroacetabular impingement pathomechanism in hips with cam and/or pincer morphologies and highlight the effect of posture on this pathomechanism. Cite this article: Bone Jt Open 2021;2(11):988–996.Maryam MohtajebJolanda CibereMichelle MonyHonglin ZhangEmily SullivanMichael A. HuntDavid R. WilsonThe British Editorial Society of Bone & Joint Surgeryarticlehipfemoroacetabular impingementbiomechanicsmrihipsfemoral headflexionfemoroacetabular impingement syndromeadductionacetabular rimarthritic hipanterior impingementhip osteoarthritis (oa)Orthopedic surgeryRD701-811ENBone & Joint Open, Vol 2, Iss 11, Pp 988-996 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	hip femoroacetabular impingement biomechanics mri hips femoral head flexion femoroacetabular impingement syndrome adduction acetabular rim arthritic hip anterior impingement hip osteoarthritis (oa) Orthopedic surgery RD701-811
spellingShingle	hip femoroacetabular impingement biomechanics mri hips femoral head flexion femoroacetabular impingement syndrome adduction acetabular rim arthritic hip anterior impingement hip osteoarthritis (oa) Orthopedic surgery RD701-811 Maryam Mohtajeb Jolanda Cibere Michelle Mony Honglin Zhang Emily Sullivan Michael A. Hunt David R. Wilson Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
description	Aims: Cam and pincer morphologies are potential precursors to hip osteoarthritis and important contributors to non-arthritic hip pain. However, only some hips with these pathomorphologies develop symptoms and joint degeneration, and it is not clear why. Anterior impingement between the femoral head-neck contour and acetabular rim in positions of hip flexion combined with rotation is a proposed pathomechanism in these hips, but this has not been studied in active postures. Our aim was to assess the anterior impingement pathomechanism in both active and passive postures with high hip flexion that are thought to provoke impingement. Methods: We recruited nine participants with cam and/or pincer morphologies and with pain, 13 participants with cam and/or pincer morphologies and without pain, and 11 controls from a population-based cohort. We scanned hips in active squatting and passive sitting flexion, adduction, and internal rotation using open MRI and quantified anterior femoroacetabular clearance using the β angle. Results: In squatting, we found significantly decreased anterior femoroacetabular clearance in painful hips with cam and/or pincer morphologies (mean -11.3° (SD 19.2°)) compared to pain-free hips with cam and/or pincer morphologies (mean 8.5° (SD 14.6°); p = 0.022) and controls (mean 18.6° (SD 8.5°); p < 0.001). In sitting flexion, adduction, and internal rotation, we found significantly decreased anterior clearance in both painful (mean -15.2° (SD 15.3°); p = 0.002) and painfree hips (mean -4.7° (SD 13°); p = 0.010) with cam and/pincer morphologies compared to the controls (mean 7.1° (SD 5.9°)). Conclusion: Our results support the anterior femoroacetabular impingement pathomechanism in hips with cam and/or pincer morphologies and highlight the effect of posture on this pathomechanism. Cite this article: Bone Jt Open 2021;2(11):988–996.
format	article
author	Maryam Mohtajeb Jolanda Cibere Michelle Mony Honglin Zhang Emily Sullivan Michael A. Hunt David R. Wilson
author_facet	Maryam Mohtajeb Jolanda Cibere Michelle Mony Honglin Zhang Emily Sullivan Michael A. Hunt David R. Wilson
author_sort	Maryam Mohtajeb
title	Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
title_short	Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
title_full	Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
title_fullStr	Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
title_full_unstemmed	Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
title_sort	open mri assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures
publisher	The British Editorial Society of Bone & Joint Surgery
publishDate	2021
url	https://doaj.org/article/4dc6e5c77ee548bd993ee05c1be799e3
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Open MRI assessment of anterior femoroacetabular clearance in active and passive impingement-provoking postures

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