Characteristics of hip impingement syndrome in patients with multiple hereditary exostoses.

Exostoses, Multiple Hereditary / complications Femoracetabular Impingement / diagnostic imaging Hip Dislocation Hip Dislocation, Congenital Hip Joint / diagnostic imaging Humans
Acetabular dysplasia Alpha angle Coxa Valga Impingement syndrome Minimum ischio-femoral distance Multiple hereditary exostoses

Journal

BMC musculoskeletal disorders
ISSN: 1471-2474
Titre abrégé: BMC Musculoskelet Disord
Pays: England
ID NLM: 100968565

Informations de publication

Date de publication:
06 Feb 2021
Historique:
received: 23 09 2020
accepted: 26 01 2021
entrez: 7 2 2021
pubmed: 8 2 2021
medline: 15 5 2021
Statut: epublish

Résumé

This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome. Between 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp's acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study. On hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp's angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp's angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4). The results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms. Level III.

Sections du résumé

BACKGROUNDS BACKGROUND
This study aimed to investigate the characteristic deformities of the hip in multiple hereditary exostoses patients (MHE) and its association with the hip impingement syndrome.
MATERIALS AND METHODS METHODS
Between 2001 and 2019, total 51 patients (102 hips) were evaluated in this study. Patients with MHE were classified to femoro-acetabular impingement (FAI) symptom group, ischio-femoral impingement (IFI) symptom group and non-impingement symptom group by comparing the symptoms, clinical signs and imaging studies. To assess the morphometry of the hip in patients with MHE, the femoral neck-shaft angle, Sharp's acetabular angle and center-edge (CE) angle were evaluated. Alpha angle was further evaluated to investigate the FAI using radiographs, and the minimum ischio-femoral distance was further measured to investigate the IFI using computed-tomographic (CT) study.
RESULTS RESULTS
On hip impingement symptom analysis, FAI symptom and IFI symptom were confirmed in 14 hip joints and 18 hip joints, respectively. Unlike general population, the number of the hip with IFI-symptom was higher than those with FAI symptom in this study. In morphometric evaluation of MHE hips, coxa valga was most prominent deformity with occasional tendency of mild acetabular dysplasia. In a comparison of morphometric study between the impingement symptom group and non-symptom group, the FAI symptom showed significant differences of morphometric measure values than those of the non-symptom group (FAI symptom group vs. Non-FAI symptom group; Femoral neck-shaft angle (153.9 vs 142.6), Sharp's angle (45.0 vs 41.5), CE angle (21.1 vs 28.8) and alpha angle (76.7 vs 57.9)). Similarly, the IFI symptom group also showed significant differences of morphometric measure values than those of the non-symptom group (IFI-symptom vs. Non-IFI symptom; Femoral neck-shaft angle (150.9 vs 142.7), Sharp's angle (44.7 vs 41.4), CE angle (21.1 vs 29.3) and alpha angle (73.3 vs 56.8)). In addition, the minimum ischio-femoral distance measured using CT was significantly decreased in the IFI symptom group (IFI symptom group: 6.6, Non-IFI symptom group: 16.4).
CONCLUSION CONCLUSIONS
The results suggest that the characteristic deformities represented by coxa valga in the MHE hip act as an offset for FAI symptoms, on the contrary, act as a trigger for IFI symptoms.
LEVEL OF EVIDENCE METHODS
Level III.

Identifiants

DOI: 10.1186/s12891-021-04021-1 PMID: 33549073 PMC: PMC7868013
pubmed: 33549073
doi: 10.1186/s12891-021-04021-1
pii: 10.1186/s12891-021-04021-1
pmc: PMC7868013
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

153

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Auteurs

Yeong-Seub Ahn (YS)

Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42 Jebongro, Donggu, Gwangju, 501-757, South Korea.

Sungmin Kim (S)

Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42 Jebongro, Donggu, Gwangju, 501-757, South Korea.

Woo-Jong Kim (WJ)

Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42 Jebongro, Donggu, Gwangju, 501-757, South Korea.

Jun-Hyuk Lim (JH)

Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42 Jebongro, Donggu, Gwangju, 501-757, South Korea.

Sung-Taek Jung (ST)

Department of Orthopaedic Surgery, Chonnam National University Hospital, Chonnam National University School of Medicine, 42 Jebongro, Donggu, Gwangju, 501-757, South Korea. stjung@jnu.ac.kr.
ORCID: 0000-0003-3936-9799

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Classifications MeSH

questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Maladies génétiques congénitales › Syndromes néoplasiques héréditaires › Maladie des exostoses multiples › Characteristics of hip impingement syndrome in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Conflit fémoro-acétabulaire › Characteristics of hip impingement syndrome in...
questionsmedicales.fr › Plaies et blessures › Traumatismes de la hanche › Luxation de la hanche › Characteristics of hip impingement syndrome in...
questionsmedicales.fr › Malformations et maladies congénitales, héréditaires et néonatales › Malformations › Malformations de l'appareil locomoteur › Luxation congénitale de la hanche › Characteristics of hip impingement syndrome in...
questionsmedicales.fr › Appareil locomoteur › Squelette › Articulations › Articulation de la hanche › Characteristics of hip impingement syndrome in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Characteristics of hip impingement syndrome in...