Valgus Hip With High Antetorsion Causes Pain Through Posterior Extraarticular FAI

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• 作者：Klaus A. Siebenrock MD (1)
  Simon Damian Steppacher MD (1)
  Pascal Cyrill Haefeli MD (1)
  Joseph Michael Schwab MD (2)
  Moritz Tannast MD (1)
  
• 刊名：Clinical Orthopaedics and Related Research?
• 出版年：2013
• 出版时间：December 2013
• 年：2013
• 卷：471
• 期：12
• 页码：3774-3780
• 全文大小：
• 作者单位：Klaus A. Siebenrock MD (1)
  Simon Damian Steppacher MD (1)
  Pascal Cyrill Haefeli MD (1)
  Joseph Michael Schwab MD (2)
  Moritz Tannast MD (1)
  
  1. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgstrasse, 3010, Bern, Switzerland
  2. Medical College of Wisconsin, Milwaukee, WI, USA
  
• ISSN：1528-1132

文摘

Background Valgus hips with increased antetorsion present with lack of external rotation and posterior hip pain that is aggravated with hip extension and external rotation. This may be the result of posterior femoroacetabular impingement (FAI). Questions/purposes We asked whether (1) the range of motion (ROM); (2) the location of anterior and posterior bony collision zones; and (3) the prevalence of extraarticular impingement differ between valgus hips with increased antetorsion compared with normal hips and hips with idiopathic FAI. Methods Surface models based on CT scan reconstructions of 13 valgus hips with increased antetorsion, 22 hips with FAI, and 27 normal hips were included. Validated three-dimensional collision detection software was used to quantify the simulated hip ROM and the location of impingement on the acetabular and the femoral sides. Results Hips with coxa valga and antetorsion showed decreased extension, external rotation, and adduction, whereas internal rotation in 90° of flexion was increased. Impingement zones were more anteroinferior on the femur and posteroinferior on the acetabular (pelvic) side; and the zones were more frequently extraarticular, posterior, or to a lesser degree anterior against the inferior iliac spine. We found a higher prevalence of extraarticular impingement for valgus hips with increased antetorsion. Conclusions Valgus hips with increased antetorsion predispose to posterior extraarticular FAI and to a lesser degree anteroinferior spine impingement. Level of Evidence Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.