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. 2015 Jul;2(2):164-9.
doi: 10.1093/jhps/hnv024. Epub 2015 Mar 31.

Is there a relationship between psoas impingement and increased trochanteric retroversion?

Juan Gómez-Hoyos  1 , Ricardo Schröder  2 , Manoj Reddy  3 , Ian J Palmer  2 , Anthony Khoury  4 , Hal David Martin  2
Affiliations

Is there a relationship between psoas impingement and increased trochanteric retroversion?

Juan Gómez-Hoyos et al. J Hip Preserv Surg. 2015 Jul.

Abstract

The concept of psoas impingement secondary to a tight or inflamed iliopsoas tendon causing impingement of the anterior labrum during hip extension has been suggested. The purpose of this study was to assess the relationship between the lesser trochanteric version (LTV) in symptomatic patients with psoas impingement as compared with asymptomatic hips. The femoral neck version (FNV) and LTV were evaluated on axial magnetic resonance imaging, as well as the angle between LTV and FNV. Data from 12 symptomatic patients and 250 asymptomatic patients were analysed. The mean, range and standard deviations were calculated. Independent t-tests were used to determine differences between groups. The lesser trochanteric retroversion was significantly increased in patients with psoas impingement as compared with asymptomatic hips (-31.1° SD ± 6.5 versus -24.2° ± 11.5, P < 0.05). The FNV (9° ± 8.8 versus 14.1° ± 10.7, P > 0.05) and the angle between FNV and LTV (40.2° ± 9.7 versus 38.3° ± 9.6, P > 0.05) were not significantly different between groups. In conclusion, the lesser trochanteric retroversion is significantly increased in patients with psoas impingement as compared with asymptomatic hips.

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Figures

Fig. 1.
Fig. 1.
The measurement process of the method was as follows: (i) two centroids were positioned in the body of lesser trochanter or femoral neck, one in the midline of the basis and a second one at the border of the tip as seen in Figs. 1A and B, (ii) the angle of the line passing between the middle of both centroids and horizontal line was called lesser trochanter or femoral neck axis, (iii) the angle between the lesser trochanter axis or femoral neck axis and the posterior condylar axis (Fig. 1C) represented the LTV and FNV, respectively. In this case, FNV = 12 and LTV = −32. A negative value means a retroverted lesser trochanter.
Fig. 2.
Fig. 2.
Patient’s selection process.
Fig. 3.
Fig. 3.
The difference on average and range between groups in FNV and FNVLTVa is similar and non-significant. However, the mean lesser trochanter retroversion is significantly more retroverted in psoas impingement group, with a range of variability more negative and smaller.
See this image and copyright information in PMC

References

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