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Diminished femoral head–neck offset and the restricted hip range of motion suggesting a possible role in ACL injuries

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

Abstract

Purpose

Femoroacetabular impingement may be associated with anterior cruciate ligament (ACL) injuries. The purpose of this study was to determine the head–neck offset, as measured by 45° Dunn’s view alpha angles, in patients with ACL injuries compared to control subjects.

Methods

In this retrospective study, 140 consecutive non-professional athletes with primary ACL ruptures confirmed with knee arthroscopy and 100 consecutive patients with non-ACL injury were enrolled. Hip range of motion was assessed in lower extremities in all participants, and alpha angle was calculated according to 45° Dunn’s view radiographs.

Results

There is not any difference in age, gender distribution, height, weight, and BMI between groups. Internal rotation, abduction, and adduction of the hip were significantly decreased in ACL-injured patients comparing with control subjects (p < 0.001). ACL-injured patients had also a significantly higher alpha angle comparing to the control individuals (p < 0.001). The mean of alpha angle in the ACL-injured patients was 56.1 (SD 10.1) and in the non-ACL-injured group was 49.3 (SD 9.4).

Conclusions

The patients in ACL-injured group showed a significant restriction in hip range of motion and also a diminished femoral head–neck offset suggesting a possible role of these findings in the outcome assessed.

Level of evidence

III.

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References

  1. Alentorn-Geli E, Mendiguchia J, Samuelsson K, Musahl V, Karlsson J, Cugat R et al (2014) Prevention of anterior cruciate ligament injuries in sports. Part I: systematic review of risk factors in male athletes. Knee Surg Sports Traumatol Arthrosc 22:3–15

    Article  PubMed  Google Scholar 

  2. Barton C, Salineros MJ, Rakhra KS, Beaule PE (2011) Validity of the alpha angle measurement on plain radiographs in the evaluation of cam-type femoroacetabular impingement. Clin Orthop Relat Res 469:464–469

    Article  PubMed  Google Scholar 

  3. 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

    Article  CAS  PubMed  Google Scholar 

  4. Bedi A, Dolan M, Leunig M, Kelly BT (2011) Static and dynamic mechanical causes of hip pain. Arthroscopy 27:235–251

    Article  PubMed  Google Scholar 

  5. Bedi A, Warren RF, Wojtys EM, Oh YK, Ashton-Miller JA, Oltean H et al (2014) Restriction in hip internal rotation is associated with an increased risk of ACL injury. Knee Surg Sports Traumatol Arthrosc 24:2024–2031

    Article  PubMed  Google Scholar 

  6. Boden BP, Torg JS, Knowles SB, Hewett TE (2009) Video analysis of anterior cruciate ligament injury: abnormalities in hip and ankle kinematics. Am J Sports Med 37:252–259

    Article  PubMed  Google Scholar 

  7. Clohisy JC, Carlisle JC, Beaule PE, Kim YJ, Trousdale RT, Sierra RJ et al (2008) A systematic approach to the plain radiographic evaluation of the young adult hip. J Bone Joint Surg Am 90(Suppl 4):47–66

    Article  PubMed  PubMed Central  Google Scholar 

  8. Draovitch P, Edelstein J, Kelly BT (2012) The layer concept: utilization in determining the pain generators, pathology and how structure determines treatment. Curr Rev Musculoskelet Med 5:1–8

    Article  PubMed  PubMed Central  Google Scholar 

  9. Ellera Gomes JL, Palma HM, Becker R (2010) Radiographic findings in restrained hip joints associated with ACL rupture. Knee Surg Sports Traumatol Arthrosc 18:1562–1567

    Article  PubMed  Google Scholar 

  10. Ellera Gomes JL, Palma HM, Ruthner R (2014) Influence of hip restriction on noncontact ACL rerupture. Knee Surg Sports Traumatol Arthrosc 22:188–191

    Article  PubMed  Google Scholar 

  11. Girard J, Krantz N, Bocquet D, Wavreille G, Migaud H (2012) Femoral head to neck offset after hip resurfacing is critical for range of motion. Clin Biomech (Bristol, Avon) 27:165–169

    Article  CAS  Google Scholar 

  12. Gomes JL, de Castro JV, Becker R (2008) Decreased hip range of motion and noncontact injuries of the anterior cruciate ligament. Arthroscopy 24:1034–1037

    Article  PubMed  Google Scholar 

  13. Ito K, Leunig M, Ganz R (2004) Histopathologic features of the acetabular labrum in femoroacetabular impingement. Clin Orthop Relat Res (429):262–271

  14. Kernozek TW, Torry MR, Iwasaki M (2008) Gender differences in lower extremity landing mechanics caused by neuromuscular fatigue. Am J Sports Med 36:554–565

    Article  PubMed  Google Scholar 

  15. Lawrence RK 3rd, Kernozek TW, Miller EJ, Torry MR, Reuteman P (2008) Influences of hip external rotation strength on knee mechanics during single-leg drop landings in females. Clin Biomech (Bristol, Avon) 23:806–813

    Article  Google Scholar 

  16. Leunig M, Beaule PE, Ganz R (2009) The concept of femoroacetabular impingement: current status and future perspectives. Clin Orthop Relat Res 467:616–622

    Article  PubMed  Google Scholar 

  17. Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J (2002) The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br 84:556–560

    Article  CAS  PubMed  Google Scholar 

  18. Oh YK, Kreinbrink JL, Wojtys EM, Ashton-Miller JA (2012) Effect of axial tibial torque direction on ACL relative strain and strain rate in an in vitro simulated pivot landing. J Orthop Res 30:528–534

    Article  PubMed  Google Scholar 

  19. Oh YK, Lipps DB, Ashton-Miller JA, Wojtys EM (2012) What strains the anterior cruciate ligament during a pivot landing? Am J Sports Med 40:574–583

    Article  PubMed  PubMed Central  Google Scholar 

  20. Philippon M, Dewing C, Briggs K, Steadman JR (2012) Decreased femoral head-neck offset: a possible risk factor for ACL injury. Knee Surg Sports Traumatol Arthrosc 20:2585–2589

    Article  PubMed  PubMed Central  Google Scholar 

  21. Pollard TC, Villar RN, Norton MR, Fern ED, Williams MR, Simpson DJ et al (2010) Femoroacetabular impingement and classification of the cam deformity: the reference interval in normal hips. Acta Orthop 81:134–141

    Article  PubMed  PubMed Central  Google Scholar 

  22. VandenBerg C, Crawford EA, Sibilsky Enselman E, Robbins CB, Wojtys EM, Bedi A (2017) Restricted hip rotation is correlated with an increased risk for anterior cruciate ligament injury. Arthroscopy 33:317–325

    Article  PubMed  Google Scholar 

  23. Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R et al (2003) Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthr Cartil 11:508–518

    Article  CAS  PubMed  Google Scholar 

  24. Williams JG (1978) Limitation of hip joint movement as a factor in traumatic osteitis pubis. Br J Sports Med 12:129–133

    Article  CAS  PubMed  PubMed Central  Google Scholar 

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Author information

Authors and Affiliations

  1. Bone and Joint Reconstruction Research Center, Shafa Yahyaeian Orthopedic Hospital, Iran University of Medical Sciences, Mojahedin Islam Avenue, Shohada Square, Tehran, 1157637131, Islamic Republic of Iran

    Abolfazl Bagherifard, Mahmoud Jabalameli, Hooman Yahyazadeh, Azadeh Shafieesabet, Kaveh Gharanizadeh & Ali Jahansouz

  2. Medical Department of Iran Football Federation, FFIRI, Tehran, Iran

    Parhan Khanlari

Authors
  1. Abolfazl Bagherifard
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  2. Mahmoud Jabalameli
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  3. Hooman Yahyazadeh
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  4. Azadeh Shafieesabet
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  5. Kaveh Gharanizadeh
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  6. Ali Jahansouz
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  7. Parhan Khanlari
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Contributions

AB and MJ contributed to conception and design and revised the manuscript. HY, KG, AJ, and PK performed acquisition of data and revised the manuscript. AS contributed to analysis and interpretation of data and drafted the manuscript.

Corresponding author

Correspondence to Hooman Yahyazadeh.

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Conflict of interest

The authors declare that they have no conflict of interest.

Funding

No external source of funding was used.

Ethical approval

All procedures performed in this study involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

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Bagherifard, A., Jabalameli, M., Yahyazadeh, H. et al. Diminished femoral head–neck offset and the restricted hip range of motion suggesting a possible role in ACL injuries. Knee Surg Sports Traumatol Arthrosc 26, 368–373 (2018). https://doi.org/10.1007/s00167-017-4589-4

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  • DOI: https://doi.org/10.1007/s00167-017-4589-4

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