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Hip Capsule Dimensions in Patients With Femoroacetabular Impingement: A Pilot Study

  • Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery
  • Published:
Clinical Orthopaedics and Related Research®

Abstract

Background

Joint-preserving hip surgery, either arthroscopic or open, increasingly is used for the treatment of symptomatic femoroacetabular impingement (FAI). As a consequence of surgery, thickening of the joint capsule and intraarticular adhesions between the labrum and joint capsule and between the femoral neck and the joint capsule have been observed. These alterations are believed to cause persistent pain and reduced range of motion. Because the diagnosis is made with MR arthrography, knowledge of the normal capsular anatomy and thickness on MRI in patients is important. To date there is no such information available.

Questions/Purposes

The purpose of this study was to establish thickness, length of the hip capsule, and the size of the perilabral recess in patients with FAI.

Methods

We reviewed the preoperative MR arthrography of 30 patients (15 men) with clinical symptoms of FAI. We measured capsular thickness and made observations on the perilabral recess.

Results

The joint capsule was thickest (6 mm) anterosuperiorly between 1 and 2 o’clock. The average length from the femoral head-neck junction to the femoral insertion of the capsule ranged from 19 to 33 mm. A perilabral recess was present circumferentially, even across the acetabular notch, where the labrum is supported by the transverse acetabular ligament. The shortest recess occurred superiorly.

Conclusions

Knowledge of the capsular anatomy in patients with FAI before surgery is important to judge the postoperative changes and to plan potential further therapy including arthroscopic treatment of intraarticular adhesions.

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Authors and Affiliations

  1. Department for Orthopaedic Surgery, Inselspital, University of Berne, 3010, Berne, Switzerland

    Jan Weidner MD & Lorenz Büchler MD

  2. Department of Orthopaedics, Canton Hospital Lucerne, Lucerne, Switzerland

    Martin Beck MD

Authors
  1. Jan Weidner MD
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  2. Lorenz Büchler MD
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  3. Martin Beck MD
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Corresponding author

Correspondence to Jan Weidner MD.

Additional information

Each author certifies that he or she, or a member of their immediate family, 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.

All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request.

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.

This work was performed at the University of Berne, Berne, Switzerland, and Kantonsspital Luzern, Lucerne, Switzerland.

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Weidner, J., Büchler, L. & Beck, M. Hip Capsule Dimensions in Patients With Femoroacetabular Impingement: A Pilot Study. Clin Orthop Relat Res 470, 3306–3312 (2012). https://doi.org/10.1007/s11999-012-2485-2

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  • DOI: https://doi.org/10.1007/s11999-012-2485-2

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