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Positive FABER distance test is associated with higher alpha angle in symptomatic patients

  • Hip
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

The purpose of this study was to determine the diagnostic value of the flexion abduction external rotation (FABER) distance test (FDT) for the diagnosis of cam-type femoroacetabular impingement (FAI) as defined by alpha angle.

Methods

For this study, 603 patients with symptomatic, unilateral femoroacetabular impingement were included. Patients with symptoms of hip instability, bilateral symptoms, bilateral surgery, or bilateral alpha angles over 55 were excluded from the analysis. A positive FDT was defined as a difference of 4 cm or more between hips. A pathological cam was defined as an alpha angle of 78° or greater.

Results

The average age was 36.4 ± 12 years, with 344 males and 259 females. Faber distance of the injured hip was correlated with age at surgery (rho = 0.148; p < 0.001). Alpha angle on the injured hip was positively correlated with injured hip FABER distance (rho = 0.276; p < 0.001). The average alpha angle in patients with a positive FABER distance test was 74° (SD = 11°) compared to 68° (SD = 8°) in patients with a negative distance test (p = 0.001). The sensitivity of the FDT to diagnose pathological cam was 0.848 (0.79–0.89) with a negative predictive value of 86% (81–90%).

Conclusion

This study demonstrated that the FABER distance test is correlated with the alpha angle and is a good diagnostic exam for pathological cam-type FAI as defined by and alpha angle equal to or greater than 78°.

Clinical relevance

FABER distance test is a simple test that can be used as a screening test to decide if FAI should be suspected and further testing is needed.

Level of evidence

III.

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Funding

No outside funding was provided for this study.

Author information

Authors and Affiliations

  1. Attn: Hip Research, Steadman Philippon Research Institute, 181 W. Meadow Dr., Suite 1000, Vail, CO, 81657, USA

    Christiano A. C. Trindade, Karen K. Briggs, Lorenzo Fagotti, Kiyokazu Fukui & Marc J. Philippon

Authors
  1. Christiano A. C. Trindade
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  2. Karen K. Briggs
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  3. Lorenzo Fagotti
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  4. Kiyokazu Fukui
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  5. Marc J. Philippon
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Corresponding author

Correspondence to Karen K. Briggs.

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Conflict of interest

Board member/owner/officer/committee appointments: Arthrocare (MJP), ISHA (MJP). Royalties: Arthrocare, DonJoy, Bledsoe, Linvatec (MJP), Vail Valley Surgery Center. Paid consultant or employee: Smith & Nephew (MJP). Research or institutional support from companies: Smith & Nephew, Ossur, Arthrex, Siemens, Vail Valley Medical Center (MJP).

Ethical approval

This study was IRB approved by the Vail Valley Medical Center IIRB under IRB protocol #2002-03.

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Trindade, C.A.C., Briggs, K.K., Fagotti, L. et al. Positive FABER distance test is associated with higher alpha angle in symptomatic patients. Knee Surg Sports Traumatol Arthrosc 27, 3158–3161 (2019). https://doi.org/10.1007/s00167-018-5031-2

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  • DOI: https://doi.org/10.1007/s00167-018-5031-2

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