Dataset Information

Preoperative and Postoperative Walking Gait in Women With Acetabular Labral Tears and Femoroacetabular Impingement Syndrome.

ABSTRACT:

Context

Symptomatic femoroacetabular impingement syndrome (FAIS) is a painful condition that leads to decreased function. How walking gait changes over time within the first year after surgery for FAIS and how these changes present in women are currently unknown.

Objective

To determine biomechanical gait differences between women with FAIS or labral tears and control individuals preoperatively and at 3 and 6 months postoperatively.

Design

Case-control study.

Setting

Laboratory.

Patients or other participants

A total of 18 female participants comprising 9 women in the FAIS group (age = 31.44 ± 7.47 years, height = 1.73 ± 0.08 m, mass = 73.61 ± 14.44 kg) and 9 women in the control group (age = 31.44 ± 6.65 years, height = 1.69 ± 0.06 m, mass = 60.93 ± 5.58 kg).

Main outcome measure(s)

Between-groups comparisons of the Hip Outcome Score Activities of Daily Living subscale (HOSADL) and gait biomechanics were conducted preoperatively and at the 3- and 6-month postoperative sessions. Statistical parametric mapping was performed on normalized time-series data.

Results

Preoperatively, the FAIS group had poor HOSADL scores (FAIS group = 64.1 ± 15.4 versus control group = 100.0 ± 0, P < .001), walked 15% slower, and exhibited several gait differences compared with the control group. Three months postoperatively, the FAIS group displayed greater vertical ground reaction force (P = .01), ankle-dorsiflexion angle (P = .02), and external dorsiflexion moment (P = .01) in midstance, as well as a greater knee-flexion angle through the second half of stance (P < .001). The FAIS group also demonstrated less hip-extension angle (P = .02) and hip-abduction angle (P = .01) through the second half of stance, which transitioned into less hip extension (P = .040) and hip abduction (P = .03) during the subsequent swing phase. The FAIS group improved their HOSADL to 87.6 ± 7.6 by 6 months postoperatively and had a greater dorsiflexion moment (P = .003) and ankle external rotation during stance (P = .03). In addition, the FAIS group showed a greater external hip external-rotation moment in late stance (P < .001).

Conclusions

The biomechanical differences between groups were most evident at 3 months postoperatively, suggesting that women with FAIS had more postoperative gait compensations in the short term after surgery. By 6 months postoperatively, patient-reported outcomes had markedly improved, and the FAIS group displayed few gait differences compared with the control group.

SUBMITTER: Freemyer B

PROVIDER: S-EPMC9661926 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Preoperative and Postoperative Walking Gait in Women With Acetabular Labral Tears and Femoroacetabular Impingement Syndrome.

Freemyer Bret B Durkin Robert R Crawford Scott S Beeler Derek D Stickley Christopher C

Journal of athletic training 20220801 8

<h4>Context</h4>Symptomatic femoroacetabular impingement syndrome (FAIS) is a painful condition that leads to decreased function. How walking gait changes over time within the first year after surgery for FAIS and how these changes present in women are currently unknown.<h4>Objective</h4>To determine biomechanical gait differences between women with FAIS or labral tears and control individuals preoperatively and at 3 and 6 months postoperatively.<h4>Design</h4>Case-control study.<h4>Setting</h4> ...[more]

PMID: 36356614

Similar Datasets

Project description:PurposeThis study sought to investigate the association between tomographic femoroacetabular impingement (FAI) angles and histologically evaluated labral tears. The authors hypothesized that cadavers presenting with cam and pincer morphologies would present a higher prevalence of acetabular labral tears.MethodsTwenty fresh cadavers were submitted to computed tomography. Standard FAI angles were measured, including the alpha angle, femoral version, acetabular version, Tonnis angle and center-edge angle. A cam lesion was defined as an alpha angle greater than 50o. A pincer lesion was defined as a center-edge angle greater than 40o, a Tonnis angle less than 0o or acetabular version less than 0o. After dissection, three fragments of each acetabulum, corresponding to the antero-superior, superior and postero-superior acetabular rim, were obtained. These fragments were submitted to routine histological preparation. Each slide was evaluated for possible labral tears. Tears were classified according to their Seldes type.ResultsThe mean age of the cadavers was 50.2 years (SD: 7.4; 13 males). Sixteen (80%) of the cadavers had a cam lesion, and eight cadavers (40%) had a pincer lesion. Histologically, 16 (80%) of the cadavers had a labral tear in at least one region. According to the Seldes classification, 60.7% and 28.6% of these labral tears were type 1 and type 2, respectively. A mixed type of labral tear (10.7%), which represented a new form of Seldes tear, was described. Cadavers with a labral tear had significantly higher alpha angles than other cadavers (53.29o vs 49.33o, p = 0.01). Pincer lesions were not associated with labral tears. We found no association between pincer or cam lesions and Seldes classification.ConclusionCadavers presenting with higher alpha angles had a higher incidence of labral tears. No association was found between FAI and Seldes classification.Clinical relevanceThis study demonstrated a high prevalence of FAI abnormalities associated with histological alterations in a cadaveric sample. Joint damage may be present in the early stages of FAI.

Project description:PurposeThe purpose of this study was to systematically review the evidence in the literature to ascertain whether acetabular labral repair (ALR) or debridement (ALD) resulted in superior patient outcomes.MethodsThe systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Peer-reviewed studies comparing ALR and ALD published in English with full text available were included. Patients undergoing both open and arthroscopic surgery in randomized controlled trials, prospective cohort studies, retrospective cohort studies, and case-control studies were included. Studies were quantified for methodological quality using the MINORS criteria. Clinical outcomes were compared, with qualitative analysis, and quantitative analyses were performed using GraphPad Prism version 7. A P value <.05 was considered to be statistically significant.ResultsThere were 8 studies included (level of evidence [LOE] I = 1; LOE II = 2; LOE III = 5). The 7 studies compared 364 patients (369 hips) with ALR to 318 patients (329 hips) with ALD, with a mean follow-up time ranging between 32-120 months. Five studies found significantly improved patient reported outcomes with ALR (Harris Hip Score, Merle d'Aubigné, Pain, SF-12). Several studies compared the outcomes after ALR and ALD and found statistical significance in all investigated metrics in favor of ALR. One study found a significant improvement in abduction but no other study found any difference in range of motion. No study found any difference in complication rate, revision rate or conversion to total hip arthroplasty. Although, 2 studies found ALR reduced the rate of osteoarthritic progression.ConclusionCurrent literature suggests that acetabular labral repair may result in superior patient reported outcomes. However, there appears to be no significant difference in the rate of progression to total hip arthroplasty at up to 10-year follow-up.Level of evidenceLevel III, systematic review of Level I, II, and III studies.

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:BackgroundFemoroacetabular impingement is increasingly recognized as a cause of hip pain but its incidence after an innominate osteotomy for the correction of acetabular dysplasia has not been determined. This information would be essential for the orthopaedic surgeon because it has the potential to produce a poor outcome in the long term when trying to balance acetabular instability and overcorrection.Questions/purposesThe purposes of our study were (1) to determine the frequency with which clinically relevant femoroacetabular impingement (FAI) occurs after an innominate osteotomy for the treatment of acetabular dysplasia; (2) to determine risk factors for the development of FAI; and (3) to compare postoperative radiographic and clinical outcomes in patients having undergone an innominate osteotomy for the correction of acetabular dysplasia both with and without FAI.MethodsThis was a retrospective review of 154 hips (132 patients) that had undergone an innominate osteotomy for acetabular dysplasia and were evaluated at a minimum followup of 10 years (mean = 12 years). Mean age at the time of surgery was 3 years, 114 hips had a concomitant open reduction, and 54 hips also had femoral shortening. One hundred eight hips had a Salter osteotomy and 46 had a Pemberton osteotomy. Radiographs were analyzed to determine the lateral center-edge angle (CE angle) and the presence of a crossover sign. The diagnosis of FAI was established when the CE angle was greater than 40°, there was a positive crossover sign, and the patient had groin pain when flexing the hip less than 90°. Comparisons between nonparametric variables were performed with a Mann-Whitney's U test. Categorical variables were compared with a chi-square test. Change in acetabular index (correction) was dichotomized considering 20° of correction as the cutoff point. Association is presented as odds ratio (95% confidence interval), and logistic regression was performed.ResultsAccording to our criteria, 18 of 154 hips had FAI (12%). Of the 18 patients with FAI, 10 had undergone a Pemberton osteotomy (10 of 46 [22%]) and eight a Salter osteotomy (eight of 108 [7%]). A change in the postoperative acetabular index greater than 20° was associated with a greater likelihood of developing FAI. The mean postoperative acetabular index was lower for the group with FAI, for whom it was 20°, compared with the group without FAI, for whom it was 27° (p = 0.04). The mean Iowa Hip Score for the group with FAI was 85, whereas for those without FAI, it was 93 (p = 0.03).ConclusionsFAI is not common after an innominate osteotomy for the treatment of acetabular dysplasia; however, overcorrection is related to a higher incidence. When FAI is present, it can affect the outcome. Overcorrection should be avoided when performing an innominate osteotomy for the treatment of acetabular dysplasia because it can create iatrogenic FAI and have an adverse effect on outcome.Level of evidenceLevel III, therapeutic study.

Dataset Information

Preoperative and Postoperative Walking Gait in Women With Acetabular Labral Tears and Femoroacetabular Impingement Syndrome.

Context

Objective

Design

Setting

Patients or other participants

Main outcome measure(s)

Results

Conclusions

Publications

Preoperative and Postoperative Walking Gait in Women With Acetabular Labral Tears and Femoroacetabular Impingement Syndrome.

Similar Datasets

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