Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Dec 19;2(1):e39-e45.
doi: 10.1016/j.asmr.2019.10.007. eCollection 2020 Feb.

Functional Results of Arthroscopic Treatment in Patients With Femoroacetabular and Subspine Impingement Diagnosed With a 3-Dimensional Dynamic Study

Bernardo Aguilera-Bohórquez  1 , Salvador Ramirez  2 , Erika Cantor  3
Affiliations

Functional Results of Arthroscopic Treatment in Patients With Femoroacetabular and Subspine Impingement Diagnosed With a 3-Dimensional Dynamic Study

Bernardo Aguilera-Bohórquez et al. Arthrosc Sports Med Rehabil. .

Abstract

Purpose: To describe the functional results of arthroscopic treatment in patients with femoroacetabular impingement (FAI) and subspine impingement (SSI) evaluated with a 3-dimensional (3D) dynamic study.

Methods: This was a retrospective observational study of patients with a diagnosis of FAI and SSI, evaluated with a 3D dynamic computed tomography scan with Move Forward software, who underwent hip arthroscopy between February 2015 and December 2017. Measurements of the alpha angle, femoral anteversion, acetabular anteversion, lateral center-edge angle, and Tönnis angle were extracted from the 3D dynamic study. Functionality was evaluated using the Western Ontario McMaster Universities Osteoarthritis Index before and 12 months after surgery.

Results: We analyzed 22 hips in 17 patients (9 female and 8 male patients) with an average age of 34.6 ± 14.3 years. Of the 22 hips, 15 had cam morphology, 6 had mixed morphology, and 1 had pincer morphology. Of the hips, 11 had a type I spine, 10 had type II, and 1 had type III. The average alpha angle, Tönnis angle, femoral anteversion, and acetabular anteversion were 61.9° ± 11.1°, 2.5° ± 6.4°, 8.8° ± 6.8°, and 15.1° ± 7.1°, respectively. The median lateral center-edge angle was 38.1° (interquartile range, 32.6°-43.5°). At 1-year follow-up, a decrease in the Western Ontario McMaster Universities Osteoarthritis Index score (P = .001) and an increase in the flexion angle (P < .001) were observed. No cases needed posterior surgical revision because of persistent pain.

Conclusions: Arthroscopic treatment provides symptom relief and good functional results in patients with FAI and SSI.

Level of evidence: Level IV, therapeutic case series.

PubMed Disclaimer

Figures

Fig 1
Fig 1
Posterior (left), lateral (Middle), and anterior (Right) views of right hip by computed tomography with 3-dimensional reconstruction. (A) Morphology of evaluated hip. (B) Hip with FAI (femoroacetabular impingement) and subspine impingement morphology (Blue zone). The abnormal contact between the anterior inferior iliac spine (AIIS) and femoral neck is evidenced.
Fig 2
Fig 2
A dynamic study of the left hip shows abnormal contact between the pelvis (anterior inferior iliac spine [AIIS]) and femoral neck (blue zone). An endoscopic view shows the resection from the acetabular rim to the AIIS, suggesting that the findings of the 3-dimensional dynamic study are reproducible in clinical practice.
Fig 3
Fig 3
(A) Computed tomography scan of left hip before surgery. The arrow points to the anterior inferior iliac spine (AIIS). (B) Computed tomography scan of left hip after decompression of AIIS (arrow).
See this image and copyright information in PMC

References

    1. Ganz R., Parvizi J., Beck M., Leunig M., Notzli H., Siebenrock K.A. Femoroacetabular impingement: A cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120. - PubMed
    1. Hetsroni I., Larson C.M., Dela Torre K., Zbeda R.M., Magennis E., Kelly B.T. Anterior inferior iliac spine deformity as an extra-articular source for hip impingement: A series of 10 patients treated with arthroscopic decompression. Arthroscopy. 2012;28:1644–1653. - PubMed
    1. Aguilera-Bohorquez B., Brugiatti M., Coaquira R., Cantor E. Frequency of subspine impingement in patients with femoroacetabular impingement evaluated with a 3-dimensional dynamic study. Arthroscopy. 2019;35:91–96. - PubMed
    1. Samim M., Walter W., Gyftopoulos S., Poultsides L., Youm T. MRI assessment of subspine impingement: Features beyond the anterior inferior iliac spine morphology. Radiology. 2019;293:412–421. - PubMed
    1. Poultsides L.A., Bedi A., Kelly B.T. An algorithmic approach to mechanical hip pain. HSS J. 2012;8:213–224. - PMC - PubMed