Femoroacetabular impingement and its implications on range of motion: A case report

被引：8

作者：

Krekel P.R. ^{[1
,2
]}

Vochteloo A.J. ^{[1
]}

Bloem R.M. ^{[3
]}

Nelissen R.G. ^{[1
]}

机构：

[1] Department of Orthopaedics, Leiden University Medical Center, Leiden

[2] Computer Graphics, Delft University of Technology, Delft

[3] Department of Orthopaedics, Reinier de Graaf Gasthuis, Delft

来源：

Journal of Medical Case Reports | / 5卷 / 1期

关键词：

Femoral Head; Femoroacetabular Impingement; Collision Detection Algorithm; Mild Degenerative Change; Pincer Type;

D O I：

10.1186/1752-1947-5-143

中图分类号：

学科分类号：

摘要：

Introduction. Femoroacetabular impingement leads to limited hip motion, pain and progressive damage to the labrum. Assessment of the amount and location of excessive ossification can be difficult, and removal does not always lead to pain relief and an increase of function. One of the challenges ahead is to discover why certain cases have poor outcomes. Case presentation. The technical and clinical results of two consecutive arthroscopic shavings of an osseous cam protrusion are described in our patient, a 50-year-old Caucasian man with complaints of femoroacetabular impingement. At 12 weeks after the first arthroscopic shaving, our patient still experienced pain. Using a range of motion simulation system based on computed tomography images the kinematics of his hip joint were analyzed. Bone that limited range of motion was removed in a second arthroscopic procedure. At six months post-operatively our patient is almost pain free and has regained a range of motion to a functional level. Conclusion: This case demonstrates the relevance of range of motion simulation when the outcome of primary arthroscopic management is unsatisfactory. Such simulations may aid clinicians in determining the gain of a second operation. This claim is supported by the correlation of the simulations with clinical outcome, as shown in this case report. © 2011 Krekel et al; licensee BioMed Central Ltd.

引用

共 16 条

[1]

Beck M., Kalhor M., Leunig M., Ganz R., Hip morphology influences the pattern of damage to the acetabular cartilage. Femoroacetabular impingement as a cause of early osteoarthritis of the hip, Journal of Bone and Joint Surgery - Series B, 87, 7, pp. 1012-1018, (2005)

[2]

Cobb J., Logishetty K., Davda K., Iranpour F., Cams and pincer impingement are distinct, not mixed: The acetabular pathomorphology of femoroacetabular impingement, Clin Orthop Relat Res, 468, pp. 2143-2151, (2010)

[3]

Larson C.M., Giveans M.R., Arthroscopic management of femoroacetabular impingement: Early outcomes measures, Arthroscopy, 24, pp. 540-546, (2008)

[4]

Philippon M.J., Schenker M.L., Briggs K.K., Kuppersmith D.A., Maxwell R.B., Stubbs A.J., Revision hip arthroscopy, American Journal of Sports Medicine, 35, 11, pp. 1918-1921, (2007)

[5]

Beck M., Leunig M., Parvizi J., Boutier V., Wyss D., Ganz R., Anterior Femoroacetabular Impingement: Part II. Midterm Results of Surgical Treatment, Clinical Orthopaedics and Related Research, 418, pp. 67-73, (2004)

[6]

Krueger A., Leunig M., Siebenrock K.A., Beck M., Hip arthroscopy after previous surgical hip dislocation for femoroacetabular impingement, Arthroscopy, 23, pp. 1285-1289, (2007)

[7]

Tannast M., Siebenrock K.A., Anderson S.E., Femoroacetabular impingement: Radiographic diagnosis - What the radiologist should know, American Journal of Roentgenology, 188, 6, pp. 1540-1552, (2007)

[8]

Wyss T.F., Clark J.M., Weishaupt D., Notzli H.P., Correlation between internal rotation and bony anatomy in the hip, Clinical Orthopaedics and Related Research, 460, pp. 152-158, (2007)

[9]

Brunner A., Horisberger M., Herzog R.F., Evaluation of a computed tomography-based navigation system prototype for hip arthroscopy in the treatment of femoroacetabular cam impingement, Arthroscopy, 25, pp. 382-391, (2009)

[10]

Lohan D.G., Seeger L.L., Motamedi K., Hame S., Sayre J., Cam-type femoral-acetabular impingement: Is the alpha angle the best MR arthrography has to offer?, Skel Radiol, 38, pp. 855-862, (2009)

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