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Clinical Orthopaedics and Related Research®

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01-12-2013 | Symposium: 2012 International Hip Society Proceedings

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Authors: Lisa M. Tibor, MD, Gunnar Liebert, MD, Reto Sutter, MD, Franco M. Impellizzeri, PhD, Michael Leunig, MD

Published in: Clinical Orthopaedics and Related Research® | Issue 12/2013

Abstract

Background

Damage to the hip can occur due to impingement or instability caused by anatomic factors such as femoral and acetabular version, neck-shaft angle, alpha angle, and lateral center-edge angle (CEA). The associations between these anatomic factors and how often they occur in a painful hip are unclear but if unaddressed might explain failed hip preservation surgery.

Questions/purposes

We determined (1) the influence of sex on the expression of impingement-related or instability-related factors, (2) the associations among these factors, and (3) how often both impingement and/or instability factors occur in the same hip.

Methods

We retrospectively reviewed a cohort of 170 hips (145 patients) undergoing MR arthrography of the hip for any reason. We excluded 58 hips with high-grade dysplasia, Perthes’ sequelae, previous surgery, or incomplete radiographic information, leaving 112 hips (96 patients). We measured femoral version and alpha angles on MR arthrograms. Acetabular anteversion, lateral CEA, and neck-shaft angle were measured on pelvic radiographs.

Results

We observed a correlation between sex and alpha angle. Weak or no correlations were observed between the other five parameters. In 66% of hips, two or more (of five) impingement parameters, and in 51% of hips, two or more (of five) instability parameters were found.

Conclusions

Patients with hip pain frequently have several anatomic factors potentially contributing to chondrolabral damage. To address pathologic hip loading due to impingement and/or instability, all of the anatomic influences should be known. As we found no associations between anatomic factors, we recommend an individualized assessment of each painful hip.

Level of Evidence

Level III, prognostic study. See Instructions for Authors for a complete description of levels of evidence.

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Title: Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain
Authors: Lisa M. Tibor, MD
Gunnar Liebert, MD
Reto Sutter, MD
Franco M. Impellizzeri, PhD
Michael Leunig, MD
Publication date: 01-12-2013
Publisher: Springer US
Published in: Clinical Orthopaedics and Related Research® / Issue 12/2013
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI: https://doi.org/10.1007/s11999-013-2918-6

2024 ASCO Annual Meeting

Springer Medicine

Two or More Impingement and/or Instability Deformities Are Often Present in Patients With Hip Pain

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

2024 ASCO Annual Meeting

Springer Medicine

Abstract

Background

Questions/purposes

Methods

Results

Conclusions

Level of Evidence

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