Clinical Orthopaedics and Related Research

, Volume 466, Issue 2, pp 273–280

Hip Damage Occurs at the Zone of Femoroacetabular Impingement

  • M. Tannast
  • D. Goricki
  • M. Beck
  • S. B. Murphy
  • K. A. Siebenrock
International Hip Society Symposium

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.

References

  1. 1.
    Beaulé PE, Zaragoza E, Motamedi K, Copelan N, Dorey FJ. Three-dimensional computed tomography of the hip in the assessment of femoroacetabular impingement. J Orthop Res. 2005;1286–1292.Google Scholar
  2. 2.
    Beck M, Kalhor M, Leunig M, Ganz R. 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. 2005;87:1012–1018.PubMedCrossRefGoogle Scholar
  3. 3.
    Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: Part II: Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.PubMedCrossRefGoogle Scholar
  4. 4.
    Cameron ML, Briggs KK, Steadman JR. Reproducibility and reliability of the Outerbridge Classification for grading chondral lesions of the Knee arthroscopically. Am J Sports Med. 2003;31:83–86.PubMedGoogle Scholar
  5. 5.
    DiGioia AM, Jaramaz B, Blackwell M, Simon DA, Morgan F, Moody JE, Nikou C, Colgan BD, Aston CA, Labarca RS, Kischell E, Kanade T. The Otto Aufranc Award: Image guided navigation system to measure intraoperatively acetabular implant alignment. Clin Orthop Relat Res. 1998;355:8–22.PubMedCrossRefGoogle Scholar
  6. 6.
    Eijer H, Leunig M, Mahomed MN, Ganz R. Crosstable lateral radiograph for screening of anterior femoral head–neck offset in patients with femoro-acetabular impingement. Hip Int. 2001;11:37–41.Google Scholar
  7. 7.
    Farjo LA, Glick JM, Sampson TG. Hip arthroscopy for acetabular labral tears. Arthroscopy. 1999;15:132–137.PubMedCrossRefGoogle Scholar
  8. 8.
    Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.PubMedGoogle Scholar
  9. 9.
    Ito K, Minka MA 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect: a MRI based quantitative anatomical study of the femoral head–neck offset. J Bone Joint Surg Br. 2001;83:171–176.PubMedCrossRefGoogle Scholar
  10. 10.
    Kim KC, Hwang DS, Lee CH, Kwon ST. Influence of femoroacetabular impingement on results of hip arthroscopy in patients with early osteoarthritis. Clin Orthop Relat Res. 2007;456:128–132.PubMedCrossRefGoogle Scholar
  11. 11.
    Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: Part I: Techniques of joint preserving surgery. Clin Orthop Relat Res. 2004;418:61–66.PubMedCrossRefGoogle Scholar
  12. 12.
    Leunig M, Podeszwa D, Beck M, Werlen S, Ganz R. Magnetic resonance arthrography of labral disorders in hips with dysplasia and impingement. Clin Orthop Relat Res. 2004;418:74–80.PubMedCrossRefGoogle Scholar
  13. 13.
    Marx RG, Connor J, Lyman S, Amendola A, Andrish JT, Kaeding C, McCarthy EC, Parker RD, Wright RW, Spindler KP. Multirater agreement of arthroscopic grading of knee articular cartilage. Am J Sports Med. 2005;33:1654–1657.PubMedCrossRefGoogle Scholar
  14. 14.
    McCarthy J, Noble P, Aluisio FV, Schuck M, Wright J, Lee JA. Anatomy, pathologic features, and treatment of acetabular labral tears. Clin Orthop Relat Res. 2003;406:38–47.PubMedCrossRefGoogle Scholar
  15. 15.
    McCarthy JC, Noble PC, Schuck MR, Wright J, Lee J. The Otto E. Aufranc Award: The role of labral lesions to development of early degenerative hip disease. Clin Orthop Relat Res. 2001;393:25–37.PubMedCrossRefGoogle Scholar
  16. 16.
    Mihata T, McGarry MH, Tibone JE, Abe M, Lee TQ. Type II SLAP lesions: a new scoring system—the sulcus score. J Shoulder Elbow Surg. 2005;14(1 Suppl S):19S–23S.PubMedCrossRefGoogle Scholar
  17. 17.
    Murphy SB, Simon SR, Kijewski PK, Wilkinson RH, Griscom T. Femoral anteversion. J Bone Joint Surg Am. 1987;69:1169–1176.PubMedGoogle Scholar
  18. 18.
    Murphy SB, Tannast M, Kim YJ, Buly R, Millis MB. Debridement of the adult hip for femoroacetabular impingement: indications and preliminary clinical results. Clin Orthop Relat Res. 2004;429:178–181.PubMedCrossRefGoogle Scholar
  19. 19.
    Nötzli HP, Wyss TF, Stöcklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head–neck-junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–560.PubMedCrossRefGoogle Scholar
  20. 20.
    Reynolds D, Lucac J, Klaue K. Retroversion of the acetabulum: a cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.PubMedCrossRefGoogle Scholar
  21. 21.
    Siebenrock KA, Schöniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion and its treatment by periacetabular osteotomy. J Bone Joint Surg Am. 2003;85:278–286.PubMedGoogle Scholar
  22. 22.
    Tannast M, Kubiak-Langer M, Langlotz F, Puls M, Murphy SB, Siebenrock KA. Noninvasive three-dimensional assessment of femoroacetabular impingement. J Orthop Res. 2007;25:122–131.PubMedCrossRefGoogle Scholar
  23. 23.
    Tannast M, Langlotz U, Siebenrock KA, Wiese M, Bernsmann K, Langlotz F. Anatomic referencing of cup orientation in total hip arthroplasty. Clin Orthop Relat Res. 2005;436:144–150.PubMedCrossRefGoogle Scholar
  24. 24.
    Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis–what the radiologist should know. AJR Am J Roentgenol. 2007;188:1540–1552.PubMedCrossRefGoogle Scholar
  25. 25.
    Tönnis D. General radiography of the hip joint. In: Tönnis D, ed. Congenital Dysplasia, Dislocation of the Hip. New York, NY: Springer; 1987:100–142.Google Scholar
  26. 26.
    Wenger DE, Kendell KR, Miner MR, Trousdale RT. Acetabular labral tears rarely occur in the absence of bony abnormalities. Clin Orthop Relat Res. 2004;426:145–150.PubMedCrossRefGoogle Scholar
  27. 27.
    Yoshida H, Faust A, Wilckens J, Kitagawa M, Fetto J, Chao EY. Three-dimensional dynamic hip contact area and pressure distribution during activities of daily living. J Biomech. 2006;39:1996–2004.PubMedCrossRefGoogle Scholar

Copyright information

© The Association of Bone and Joint Surgeons 2008

Authors and Affiliations

  • M. Tannast
    • 1
  • D. Goricki
    • 1
  • M. Beck
    • 1
  • S. B. Murphy
    • 2
  • K. A. Siebenrock
    • 1
  1. 1.Department of Orthopaedic Surgery, InselspitalUniversity of BernMurtenstrasseSwitzerland
  2. 2.Center for Computer Assisted and Reconstructive Surgery, New England Baptist HospitalTufts UniversityBostonUSA

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