, Volume 466, Issue 2, pp 273-280
Date: 10 Jan 2008

Hip Damage Occurs at the Zone of Femoroacetabular Impingement

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Abstract

Although current concepts of anterior femoroacetabular impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type femoroacetabular impingement (Group I) with the locations of femoroacetabular impingement in 15 additional hips using computer simulation (Group II). We found no difference between the mean locations of the chondrolabral damage of Group I and the computed impingement zone of Group II. The standard deviation was larger for measures of articular damage from Group I in comparison to the computed values of Group II. The most severe hip damage occurred at the zone of highest probability of femoroacetabular impact, typically in the anterosuperior quadrant of the acetabulum for both cam and pincer type femoroacetabular impingements. However, the extent of joint damage along the acetabular rim was larger intraoperatively than that observed on the images of the 3-D joint simulations. We concluded femoroacetabular impingement mechanism contributes to early osteoarthritis including labral lesions.

Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.

One or more of the authors has received funding from the National Center for Competence in Research “Computer Aided and Image Guided Medical Interventions (Co-Me)” (MT, KAS), a fellowship for prospective researchers of the Swiss National Science Foundation (SNF) (MT), a Travel Fellowship Award from the International Society for Computer Assisted Orthopaedic Surgery (CAOS International) (MT), and the 2005 Research Grant Award from the New England Baptist Hospital (MT, SBM).
Each author certifies that his or her institution has approved the human protocol for this investigation, that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.