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The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint

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Abstract

Gait analysis is an objective tool that has been used to assess and monitor treatment for many musculoskeletal conditions. Recently, it has been used to assess the impact of femoro-acetabular impingement (FAI) on the hip and lower limb movements. There have been a fairly limited number of studies published so far reporting unexpected and inconsistent results, which calls for more research to be conducted in this arena. In the light of the limited data available, it has been challenging to reconcile the contradictions in some of these results, and therefore no coherent conclusions could be drawn. In this short article, we attempt to explain some of the abnormal kinematic and kinetic patterns associated with FAI by highlighting similarities between the gait seen in early osteoarthritis (OA) and that of FAI. We also propose an approach for future research in this field and emphasise the importance of quantifying early OA in FAI based on magnetic resonance imaging (MRI) scans and the amount of chondral damage seen during open or arthroscopic surgery.

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References

  1. Audenaert EA, Peeters I, Vigneron L, Baelde N, Pattyn C (2012) Hip morphological characteristics and range of internal rotation in femoroacetabular impingement. Am J Sports Med 40:1329–1336. doi:10.1177/0363546512441328

    Article  PubMed  Google Scholar 

  2. Leunig M, Beaulé PE, Ganz R (2009) The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res 467:616–622. doi:10.1007/s11999-008-0646-0

    Article  PubMed Central  PubMed  Google Scholar 

  3. Anderson SE, Siebenrock KA, Tannast M (2010) Femoroacetabular impingement: evidence of an established hip abnormality. Radiology 257:8–13. doi:10.1148/radiol.10091480

    Article  PubMed  Google Scholar 

  4. Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R (2001) Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br 83:171–176

    Article  CAS  PubMed  Google Scholar 

  5. Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R (2005) Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology 236:237–246. doi:10.1148/radiol.2361040140

    Article  PubMed  Google Scholar 

  6. Imam S, Khanduja V (2011) Current concepts in the diagnosis and management of femoroacetabular impingement. Int Orthop 35:1427–1435. doi:10.1007/s00264-011-1278-7

    Article  PubMed Central  PubMed  Google Scholar 

  7. Lamontagne M, Kennedy MJ, Beaulé PE (2009) The effect of cam FAI on hip and pelvic motion during maximum squat. Clin Orthop Relat Res 467:645–650. doi:10.1007/s11999-008-0620-x

    Article  PubMed Central  PubMed  Google Scholar 

  8. Pfirrmann CW, Mengiardi B, Dora C, Kalberer F, Zanetti M, Hodler J (2006) Cam and pincer femoroacetabular impingement: characteristic MR arthrographic findings in 50 patients. Radiology 240:778–785. doi:10.1148/radiol.2403050767

    Article  PubMed  Google Scholar 

  9. Tannast M, Siebenrock KA, Anderson SE (2007) Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know. AJR Am J Roentgenol 188:1540–1552. doi:10.2214/AJR.06.0921

    Article  PubMed  Google Scholar 

  10. Beall DP, Sweet CF, Martin HD, Lastine CL, Grayson DE, Ly JQ, Fish JR (2005) Imaging findings of femoroacetabular impingement syndrome. Skeletal Radiol 34:691–701. doi:10.1007/s00256-005-0932-9

    Article  PubMed  Google Scholar 

  11. Agricola R, Heijboer MP, Bierma-Zeinstra SM, Verhaar JA, Weinans H, Waarsing JH (2013) Cam impingement causes osteoarthritis of the hip: a nationwide prospective cohort study (CHECK). Ann Rheum Dis 72:918–923. doi:10.1136/annrheumdis-2012-201643

    Article  PubMed  Google Scholar 

  12. Beck M, Kalhor M, Leunig M, Ganz R (2005) Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br 87:1012–1018. doi:10.1302/0301-620X.87B7.15203

    Article  CAS  PubMed  Google Scholar 

  13. Takeyama A, Naito M, Shiramizu K, Kiyama T (2009) Prevalence of femoroacetabular impingement in Asian patients with osteoarthritis of the hip. Int Orthop 33:1229–1232. doi:10.1007/s00264-009-0742-0

    Article  PubMed Central  PubMed  Google Scholar 

  14. Cavaignac E, Chiron P, Espié A, Reina N, Lepage B, Laffosse JM (2012) Experimental study of an original radiographic view for diagnosis of cam-type anterior femoroacetabular impingement. Int Orthop 36:1783–1788. doi:10.1007/s00264-012-1550-5

    Article  PubMed Central  PubMed  Google Scholar 

  15. Papalia R, Del Buono A, Franceschi F, Marinozzi A, Maffulli N, Denaro V (2012) Femoroacetabular impingement syndrome management: arthroscopy or open surgery? Int Orthop 36:903–914. doi:10.1007/s00264-011-1443-z

    Article  PubMed Central  PubMed  Google Scholar 

  16. Khanduja V, Villar RN (2007) The arthroscopic management of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 15:1035–1040. doi:10.1007/s00167-007-0319-7

    Article  PubMed  Google Scholar 

  17. Bedi A, Kelly BT, Khanduja V (2013) Arthroscopic hip preservation surgery: current concepts and perspective. Bone Joint J 95-B:10–19. doi:10.1302/0301-620X.95B1.29608

    Article  CAS  PubMed  Google Scholar 

  18. Kadaba MP, Ramakrishnan HK, Wootten ME (1990) Measurement of lower extremity kinematics during level walking. J Orthop Res 8:383–392. doi:10.1002/jor.1100080310

    Article  CAS  PubMed  Google Scholar 

  19. Ornetti P, Maillefert JF, Laroche D, Morisset C, Dougados M, Gossec L (2010) Gait analysis as a quantifiable outcome measure in hip or knee osteoarthritis: a systematic review. Joint Bone Spine 77:421–425. doi:10.1016/j.jbspin.2009.12.009

    Article  PubMed  Google Scholar 

  20. Rylander JH, Shu B, Andriacchi TP, Safran MR (2011) Preoperative and postoperative sagittal plane hip kinematics in patients with femoroacetabular impingement during level walking. Am J Sports Med 39(Suppl):36S–42S. doi:10.1177/0363546511413993

    Article  PubMed  Google Scholar 

  21. Paoloni M, Di Sante L, Dimaggio M, Bernetti A, Mangone M, Di Renzo S, Santilli V (2012) Kinematic and kinetic modifications in walking pattern of hip osteoarthritis patients induced by intra-articular injections of hyaluronic acid. Clin Biomech (Bristol, Avon) 27:661–665. doi:10.1016/j.clinbiomech.2012.02.004

    Article  Google Scholar 

  22. Ewen AM, Stewart S, St Clair Gibson A, Kashyap SN, Caplan N (2012) Post-operative gait analysis in total hip replacement patients-a review of current literature and meta-analysis. Gait Posture 36:1–6. doi:10.1016/j.gaitpost.2011.12.024

    Article  PubMed  Google Scholar 

  23. Brisson N, Lamontagne M, Kennedy MJ, Beaulé PE (2013) The effects of cam femoroacetabular impingement corrective surgery on lower-extremity gait biomechanics. Gait Posture 37:258–263. doi:10.1016/j.gaitpost.2012.07.016

    Article  PubMed  Google Scholar 

  24. Zebala LP, Schoenecker PL, Clohisy JC (2007) Anterior femoroacetabular impingement: a diverse disease with evolving treatment options. Iowa Orthop J 27:71–81

    PubMed Central  PubMed  Google Scholar 

  25. Gore TA, Higginson GR, Stevens J (1984) The kinematics of hip joints: normal functioning. Clin Phys Physiol Meas 5:233–252

    Article  CAS  PubMed  Google Scholar 

  26. McGinley JL, Baker R, Wolfe R, Morris ME (2009) The reliability of three-dimensional kinematic gait measurements: a systematic review. Gait Posture 29:360–369. doi:10.1016/j.gaitpost.2008.09.003

    Article  PubMed  Google Scholar 

  27. Rab GT (1999) The geometry of slipped capital femoral epiphysis: implications for movement, impingement, and corrective osteotomy. J Pediatr Orthop 19:419–424

    Article  CAS  PubMed  Google Scholar 

  28. Kennedy MJ, Lamontagne M, Beaulé PE (2009) Femoroacetabular impingement alters hip and pelvic biomechanics during gait: walking biomechanics of FAI. Gait Posture 30:41–44. doi:10.1016/j.gaitpost.2009.02.008

    Article  PubMed  Google Scholar 

  29. Hunt MA, Gunether JR, Gilbart MK (2013) Kinematic and kinetic differences during walking in patients with and without symptomatic femoroacetabular impingement. Clin Biomech (Bristol, Avon) 28:519–523. doi:10.1016/j.clinbiomech.2013.05.002

    Article  Google Scholar 

  30. Roaas A, Andersson GB (1982) Normal range of motion of the hip, knee and ankle joints in male subjects, 30–40 years of age. Acta Orthop Scand 53:205–208

    Article  CAS  PubMed  Google Scholar 

  31. Bedi A, Dolan M, Hetsroni I, Magennis E, Lipman J, Buly R, Kelly BT (2011) Surgical treatment of femoroacetabular impingement improves hip kinematics: a computer-assisted model. Am J Sports Med 39(Suppl):43S–49S. doi:10.1177/0363546511414635

    Article  PubMed  Google Scholar 

  32. Kubiak-Langer M, Tannast M, Murphy SB, Siebenrock KA, Langlotz F (2007) Range of motion in anterior femoroacetabular impingement. Clin Orthop Relat Res 458:117–124. doi:10.1097/BLO.0b013e318031c595

    CAS  PubMed  Google Scholar 

  33. Clohisy JC, Knaus ER, Hunt DM, Lesher JM, Harris-Hayes M, Prather H (2009) Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res 467:638–644. doi:10.1007/s11999-008-0680-y

    Article  PubMed Central  PubMed  Google Scholar 

  34. Philippon MJ, Maxwell RB, Johnston TL, Schenker M, Briggs KK (2007) Clinical presentation of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc 15:1041–1047. doi:10.1007/s00167-007-0348-2

    Article  PubMed  Google Scholar 

  35. Casartelli NC, Leunig M, Item-Glatthorn JF, Lepers R, Maffiuletti NA (2012) Hip flexor muscle fatigue in patients with symptomatic femoroacetabular impingement. Int Orthop 36:967–973. doi:10.1007/s00264-011-1385-5

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Casartelli NC, Maffiuletti NA, Item-Glatthorn JF, Staehli S, Bizzini M, Impellizzeri FM, Leunig M (2011) Hip muscle weakness in patients with symptomatic femoroacetabular impingement. Osteoarthritis Cartilage 19:816–821. doi:10.1016/j.joca.2011.04.001

    Article  CAS  PubMed  Google Scholar 

  37. Hurwitz DE, Hulet CH, Andriacchi TP, Rosenberg AG, Galante JO (1997) Gait compensations in patients with osteoarthritis of the hip and their relationship to pain and passive hip motion. J Orthop Res 15:629–635. doi:10.1002/jor.1100150421

    Article  CAS  PubMed  Google Scholar 

  38. Foucher KC, Schlink BR, Shakoor N, Wimmer MA (2012) Sagittal plane hip motion reversals during walking are associated with disease severity and poorer function in subjects with hip osteoarthritis. J Biomech 45:1360–1365. doi:10.1016/j.jbiomech.2012.03.008

    Article  PubMed  Google Scholar 

  39. Ganz R, Leunig M, Leunig-Ganz K, Harris WH (2008) The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res 466:264–272. doi:10.1007/s11999-007-0060-z

    Article  PubMed Central  PubMed  Google Scholar 

  40. Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA (2003) Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res 417:112–120. doi:10.1097/01.blo.0000096804.78689.c2

    Google Scholar 

  41. Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R, Siebenrock KA (2003) Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage 11:508–518

    Article  CAS  PubMed  Google Scholar 

  42. Eitzen I, Fernandes L, Nordsletten L, Risberg MA (2012) Sagittal plane gait characteristics in hip osteoarthritis patients with mild to moderate symptoms compared to healthy controls: a cross-sectional study. BMC Musculoskelet Disord 13:258. doi:10.1186/1471-2474-13-258

    Article  PubMed Central  PubMed  Google Scholar 

  43. Olsson E (1986) Gait analysis in hip and knee surgery. Scand J Rehabil Med Suppl 15:1–55

    CAS  PubMed  Google Scholar 

  44. Hartofilakidis G, Bardakos NV, Babis GC, Georgiades G (2011) An examination of the association between different morphotypes of femoroacetabular impingement in asymptomatic subjects and the development of osteoarthritis of the hip. J Bone Joint Surg Br 93:580–586. doi:10.1302/0301-620X.93B5.25236

    Article  CAS  PubMed  Google Scholar 

  45. Hack K, Di Primio G, Rakhra K, Beaulé PE (2010) Prevalence of cam-type femoroacetabular impingement morphology in asymptomatic volunteers. J Bone Joint Surg Am 92:2436–2444. doi:10.2106/JBJS.J.01280

    Article  PubMed  Google Scholar 

  46. Laborie LB, Lehmann TG, Engesæter IØ, Eastwood DM, Engesæter LB, Rosendahl K (2011) Prevalence of radiographic findings thought to be associated with femoroacetabular impingement in a population-based cohort of 2081 healthy young adults. Radiology 260:494–502. doi:10.1148/radiol.11102354

    Article  PubMed  Google Scholar 

  47. Şahin N, Atici T, Öztürk A, Özkaya G, Özkan Y, Avcu B (2011) Prevalence of femoroacetabular impingement in asymptomatic contralateral hips in patients with unilateral idiopathic osteoarthritis. J Int Med Res 39:790–797

    Article  PubMed  Google Scholar 

  48. Sankar WN, Arden N, Kim YJ, Grodzinsky AJ, Sandell L, Scanzello C, Siebenrock KA (2013) Staging of hip osteoarthritis for clinical trials on femoroacetabular impingement. J Am Acad Orthop Surg 21(Suppl 1):S33–S38. doi:10.5435/JAAOS-21-07-S3321/suppl/S33

    Article  PubMed  Google Scholar 

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  1. Department of Trauma and Orthopaedics, Addenbrooke’s – Cambridge University Hospitals NHS Foundation Trust, Box 37, Hills Road, Cambridge, CB2 0QQ, UK

    Zeiad Alshameeri & Vikas Khanduja

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  1. Zeiad Alshameeri
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  2. Vikas Khanduja
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Correspondence to Vikas Khanduja.

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Alshameeri, Z., Khanduja, V. The effect of femoro-acetabular impingement on the kinematics and kinetics of the hip joint. International Orthopaedics (SICOT) 38, 1615–1620 (2014). https://doi.org/10.1007/s00264-014-2302-5

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