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Radiographic analysis of subclinical appearances of the hip joint among patients with labral tears.

ABSTRACT: OBJECTIVE:Labral tears can be complicated by hip diseases, including osteoarthritis or femoral acetabular impingement. To accurately plan hip arthroscopy or subsequent conversion to total hip arthroplasty, the presence of bony abnormalities in the hip joint must be evaluated. This study aimed to elucidate the utility of multiplanar reconstruction computed tomography (mCT) for the detection of subclinical coincidence of osteoarthritis or femoral acetabular impingement with a labrum tear. MATERIALS AND METHODS:We retrospectively analysed 34 patients (36 hips) with labrum tears without apparent osteoarthritis or hip dysplasia from 2012 to 2015. The joint spaces were calculated using radiographs or mCT, and the detection rates of degenerative cyst and herniation pit were compared. RESULTS:Narrow joint spaces (

SUBMITTER: Aiba H

PROVIDER: S-EPMC6854768 | biostudies-literature | 2019 Nov

REPOSITORIES: biostudies-literature

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Radiographic analysis of subclinical appearances of the hip joint among patients with labral tears.

Aiba Hisaki H Watanabe Nobuyuki N Fukuoka Muneyoshi M Wada Ikuo I Murakami Hideki H

Journal of orthopaedic surgery and research 20191114 1

<h4>Objective</h4>Labral tears can be complicated by hip diseases, including osteoarthritis or femoral acetabular impingement. To accurately plan hip arthroscopy or subsequent conversion to total hip arthroplasty, the presence of bony abnormalities in the hip joint must be evaluated. This study aimed to elucidate the utility of multiplanar reconstruction computed tomography (mCT) for the detection of subclinical coincidence of osteoarthritis or femoral acetabular impingement with a labrum tear.< ...[more]

PMID: 31727125

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Project description:BackgroundIt remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears.PurposeTo review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV.Study designSystematic review; Level of evidence, 4.MethodsEmbase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score-Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable.ResultsIncluded in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), -3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, -0.70 [96% CI, -8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, -3.09 [95% CI, -7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, -1.92 [95% CI, -6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04).ConclusionThe results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

Project description:To determine if contact forces and electromyography (EMG) muscle amplitudes were altered during the lunge for patients with symptomatic labral tears compared with asymptomatic control subjects.Surface electromyography electrodes were placed over the gluteus medius, gluteus maximus, adductor longus, and rectus femoris muscles of the patients' involved limb and matched limb of asymptomatic controls. Subjects performed 3 trials of the lunge on a clinical force platform. An electrogoniometer tracked knee flexion motion during testing. Average root mean squared EMG muscle amplitudes for each muscle were calculated for the descent and ascent phases of the lunge, represented as a percentage of maximum activity (%MVIC). Peak knee flexion was calculated from the goniometer (°). The dependent variables from the force platform were lunge distance (%height), contact time (seconds), vertical impact force (%BW), and force impulse (%BW*s). Dependent variables were compared between groups using either independent samples t tests or Mann-Whitney U tests. Relations between dependent variables were assessed with Spearman Rho correlation coefficients. The level of significance was set at P ≤ .05.Twenty-one patients with symptomatic unilateral labral tears (14 females, 7 males) and 17 asymptomatic control subjects (11 females, 6 males) participated in this study. Average gluteus maximus EMG muscle amplitudes were reduced for symptomatic labral patients compared with asymptomatic controls during lunge ascent (51.6 ± 31.1 v 71.7 ± 36.3 [mean difference (MD): 20.1% (-2.4%, 42.6%)], P = .042). Average vertical impact force was reduced (21.8 ± 5.5 v 26.8 ± 7.3 [MD: 5.1%BW (0.84%BW, 9.3%BW)], P = .02) and average contact time (1.8 ± 0.4 v 1.5 ± 0.4 [MD: 0.27 seconds (0.006 seconds, 0.54 seconds)], P = .045) and force impulse (188.4 ± 42.4 v 162.6 ± 33.3 [MD: 25.8%BW*s (0.3%BW*s, 51.4%BW*s)], P = .042) were increased for symptomatic labral patients compared with asymptomatic controls. Vertical impact force was inversely correlated with gluteus medius muscle amplitudes during lunge descent for symptomatic labral patients (r = -0.452, P = .045).Our study shows that contact forces and EMG muscle amplitudes are altered during the lunge for patients with symptomatic labral tears. The presence of a relation between muscle amplitudes and contact forces suggests that targeting muscle impairments may restore function in these patients.Level III, case-control study.

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Radiographic analysis of subclinical appearances of the hip joint among patients with labral tears.

Publications

Radiographic analysis of subclinical appearances of the hip joint among patients with labral tears.

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