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Clinical Presentation of Patients with Symptomatic Anterior Hip Impingement

  • Symposium: Femoroacetabular Impingement: Current Status of Diagnosis and Treatment
  • Published:
Clinical Orthopaedics and Related Research

Abstract

Femoroacetabular impingement (FAI) is considered a cause of labrochondral disease and secondary osteoarthritis. Nevertheless, the clinical syndrome associated with FAI is not fully characterized. We determined the clinical history, functional status, activity status, and physical examination findings that characterize FAI. We prospectively evaluated 51 patients (52 hips) with symptomatic FAI. Evaluation of the clinical history, physical exam, and previous treatments was performed. Patients completed demographic and validated hip questionnaires (Baecke et al., SF-12, Modified Harris hip, and UCLA activity score). The average patient age was 35 years and 57% were male. Symptom onset was commonly insidious (65%) and activity-related. Pain occurred predominantly in the groin (83%). The mean time from symptom onset to definitive diagnosis was 3.1 years. Patients were evaluated by an average 4.2 healthcare providers prior to diagnosis and inaccurate diagnoses were common. Thirteen percent had unsuccessful surgery at another anatomic site. On exam, 88% of the hips were painful with the anterior impingement test. Hip flexion and internal rotation in flexion were limited to an average 97° and 9°, respectively. The patients were relatively active, yet demonstrated restrictions of function and overall health. These data may facilitate diagnosis of this disorder.

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

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery, Washington University School of Medicine, One Barnes-Jewish Plaza, Suite 11300 West Pavilion, Campus Box 8233, St. Louis, MO, 63110, USA

    John C. Clohisy MD

  2. Physical Medicine and Rehabilitation Section of the Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA

    Evan R. Knaus DO, Devyani M. Hunt MD, John M. Lesher MD & Heidi Prather DO

  3. Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO, USA

    Marcie Harris-Hayes PT

Authors
  1. John C. Clohisy MD
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  2. Evan R. Knaus DO
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  3. Devyani M. Hunt MD
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  4. John M. Lesher MD
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  5. Marcie Harris-Hayes PT
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  6. Heidi Prather DO
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Corresponding author

Correspondence to John C. Clohisy MD.

Additional information

Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Partial support was received from a Zimmer Clinical Research Grant (JCC). This work was supported in part by Award Number UL1RR024992 from the National Center for Research Resources (JCC). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Center for Research Resources or the National Institutes of Health. This work was also supported in part by the Curing Hip Disease Fund (JCC).

Each author certifies that his or her institution has approved the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research, and that informed consent for participation in the study was obtained.

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Clohisy, J.C., Knaus, E.R., Hunt, D.M. et al. Clinical Presentation of Patients with Symptomatic Anterior Hip Impingement. Clin Orthop Relat Res 467, 638–644 (2009). https://doi.org/10.1007/s11999-008-0680-y

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  • DOI: https://doi.org/10.1007/s11999-008-0680-y

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