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Erschienen in: Clinical Orthopaedics and Related Research® 12/2012

01.12.2012 | Symposium: ABJS Carl T. Brighton Workshop on Hip Preservation Surgery

Hip Capsule Dimensions in Patients With Femoroacetabular Impingement: A Pilot Study

verfasst von: Jan Weidner, MD, Lorenz Büchler, MD, Martin Beck, MD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 12/2012

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Abstract

Background

Joint-preserving hip surgery, either arthroscopic or open, increasingly is used for the treatment of symptomatic femoroacetabular impingement (FAI). As a consequence of surgery, thickening of the joint capsule and intraarticular adhesions between the labrum and joint capsule and between the femoral neck and the joint capsule have been observed. These alterations are believed to cause persistent pain and reduced range of motion. Because the diagnosis is made with MR arthrography, knowledge of the normal capsular anatomy and thickness on MRI in patients is important. To date there is no such information available.

Questions/Purposes

The purpose of this study was to establish thickness, length of the hip capsule, and the size of the perilabral recess in patients with FAI.

Methods

We reviewed the preoperative MR arthrography of 30 patients (15 men) with clinical symptoms of FAI. We measured capsular thickness and made observations on the perilabral recess.

Results

The joint capsule was thickest (6 mm) anterosuperiorly between 1 and 2 o’clock. The average length from the femoral head-neck junction to the femoral insertion of the capsule ranged from 19 to 33 mm. A perilabral recess was present circumferentially, even across the acetabular notch, where the labrum is supported by the transverse acetabular ligament. The shortest recess occurred superiorly.

Conclusions

Knowledge of the capsular anatomy in patients with FAI before surgery is important to judge the postoperative changes and to plan potential further therapy including arthroscopic treatment of intraarticular adhesions.
Literatur
1.
Zurück zum Zitat Beck M. Groin pain after open FAI surgery: the role of intraarticular adhesions. Clin Orthop Relat Res. 2009;467:769–774.PubMedCrossRef Beck M. Groin pain after open FAI surgery: the role of intraarticular adhesions. Clin Orthop Relat Res. 2009;467:769–774.PubMedCrossRef
2.
Zurück zum Zitat 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. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef 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. J Bone Joint Surg Br. 2005;87:1012–1018.PubMedCrossRef
3.
Zurück zum Zitat Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.PubMedCrossRef Beck M, Leunig M, Parvizi J, Boutier V, Wyss D, Ganz R. Anterior femoroacetabular impingement: part II. Midterm results of surgical treatment. Clin Orthop Relat Res. 2004;418:67–73.PubMedCrossRef
4.
Zurück zum Zitat Dudda M, Albers C, Mamisch TC, Werlen S, Beck M. Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res. 2009;467:651–659.PubMedCrossRef Dudda M, Albers C, Mamisch TC, Werlen S, Beck M. Do normal radiographs exclude asphericity of the femoral head-neck junction? Clin Orthop Relat Res. 2009;467:651–659.PubMedCrossRef
5.
Zurück zum Zitat Dudda M, Mamisch TC, Krueger A, Werlen S, Siebenrock KA, Beck M. Hip arthroscopy after surgical hip dislocation: is predictive imaging possible? Arthroscopy. 2011;27:486–492.PubMedCrossRef Dudda M, Mamisch TC, Krueger A, Werlen S, Siebenrock KA, Beck M. Hip arthroscopy after surgical hip dislocation: is predictive imaging possible? Arthroscopy. 2011;27:486–492.PubMedCrossRef
6.
Zurück zum Zitat Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am. 2007;89(Suppl 2):36–53.PubMedCrossRef Espinosa N, Beck M, Rothenfluh DA, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. Surgical technique. J Bone Joint Surg Am. 2007;89(Suppl 2):36–53.PubMedCrossRef
7.
Zurück zum Zitat Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88:925–935.PubMedCrossRef Espinosa N, Rothenfluh DA, Beck M, Ganz R, Leunig M. Treatment of femoro-acetabular impingement: preliminary results of labral refixation. J Bone Joint Surg Am. 2006;88:925–935.PubMedCrossRef
8.
Zurück zum Zitat Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip. A technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83:1119–1124.PubMedCrossRef Ganz R, Gill TJ, Gautier E, Ganz K, Krügel N, Berlemann U. Surgical dislocation of the adult hip. A technique with full access to the femoral head and acetabulum without the risk of avascular necrosis. J Bone Joint Surg Br. 2001;83:1119–1124.PubMedCrossRef
9.
Zurück zum Zitat Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.PubMed Ganz R, Parvizi J, Beck M, Leunig M, Nötzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003;417:112–120.PubMed
10.
Zurück zum Zitat Haupt U, Völkle D, Waldherr C, Beck M. Intra- and retroperitoneal irrigation liquid after arthroscopy of the hip joint. Arthroscopy. 2008;24:966–968.PubMedCrossRef Haupt U, Völkle D, Waldherr C, Beck M. Intra- and retroperitoneal irrigation liquid after arthroscopy of the hip joint. Arthroscopy. 2008;24:966–968.PubMedCrossRef
11.
Zurück zum Zitat Kelly BT, Williams RJ 3rd, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med. 2003;31:1020–1037.PubMed Kelly BT, Williams RJ 3rd, Philippon MJ. Hip arthroscopy: current indications, treatment options, and management issues. Am J Sports Med. 2003;31:1020–1037.PubMed
12.
Zurück zum Zitat Krueger A, Leunig M, Siebenrock KA, Beck M. Hip arthroscopy after previous surgical hip dislocation for femoroacetabular impingement. Arthroscopy. 2007;23:1285–1289.PubMedCrossRef Krueger A, Leunig M, Siebenrock KA, Beck M. Hip arthroscopy after previous surgical hip dislocation for femoroacetabular impingement. Arthroscopy. 2007;23:1285–1289.PubMedCrossRef
13.
Zurück zum Zitat Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res. 2004;418:61–66.PubMedCrossRef Lavigne M, Parvizi J, Beck M, Siebenrock KA, Ganz R, Leunig M. Anterior femoroacetabular impingement: part I. Techniques of joint preserving surgery. Clin Orthop Relat Res. 2004;418:61–66.PubMedCrossRef
14.
Zurück zum Zitat Leunig M, Beck M, Dora C, Ganz R. [Femoroacetabular impingement: trigger for the development of coxarthrosis] [in German]. Orthopade. 2006;35:77–84.PubMedCrossRef Leunig M, Beck M, Dora C, Ganz R. [Femoroacetabular impingement: trigger for the development of coxarthrosis] [in German]. Orthopade. 2006;35:77–84.PubMedCrossRef
15.
Zurück zum Zitat Petersen W, Petersen F, Tillmann B. Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions. Arch Orthop Trauma Surg. 2003;123:283–288.PubMedCrossRef Petersen W, Petersen F, Tillmann B. Structure and vascularization of the acetabular labrum with regard to the pathogenesis and healing of labral lesions. Arch Orthop Trauma Surg. 2003;123:283–288.PubMedCrossRef
16.
Zurück zum Zitat Philippon MJ. New frontiers in hip arthroscopy: the role of arthroscopic hip labral repair and capsulorrhaphy in the treatment of hip disorders. Instr Course Lect. 2006;55:309–316.PubMed Philippon MJ. New frontiers in hip arthroscopy: the role of arthroscopic hip labral repair and capsulorrhaphy in the treatment of hip disorders. Instr Course Lect. 2006;55:309–316.PubMed
17.
Zurück zum Zitat Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2009;91:16–23.PubMedCrossRef Philippon MJ, Briggs KK, Yen YM, Kuppersmith DA. Outcomes following hip arthroscopy for femoroacetabular impingement with associated chondrolabral dysfunction: minimum two-year follow-up. J Bone Joint Surg Br. 2009;91:16–23.PubMedCrossRef
18.
Zurück zum Zitat Philippon MJ, Weiss DR, Kuppersmith DA, Briggs KK, Hay CJ. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med. 2010;38:99–104.PubMedCrossRef Philippon MJ, Weiss DR, Kuppersmith DA, Briggs KK, Hay CJ. Arthroscopic labral repair and treatment of femoroacetabular impingement in professional hockey players. Am J Sports Med. 2010;38:99–104.PubMedCrossRef
19.
Zurück zum Zitat Philippon MJ, Yen YM, Briggs KK, Kuppersmith DA, Maxwell RB. Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: a preliminary report. J Pediatr Orthop. 2008;28:705–710.PubMedCrossRef Philippon MJ, Yen YM, Briggs KK, Kuppersmith DA, Maxwell RB. Early outcomes after hip arthroscopy for femoroacetabular impingement in the athletic adolescent patient: a preliminary report. J Pediatr Orthop. 2008;28:705–710.PubMedCrossRef
20.
Zurück zum Zitat Putz R, Schrank C. [Anatomy of the labro-capsular complex] [in German]. Orthopade. 1998;27:675–680.PubMed Putz R, Schrank C. [Anatomy of the labro-capsular complex] [in German]. Orthopade. 1998;27:675–680.PubMed
21.
Zurück zum Zitat Werlen S, Leunig M, Ganz R. Magnetic resonance arthrography of the hip in femoroacetabular impingement: technique and findings. Oper Tech Orthop. 2005;15:191–203.CrossRef Werlen S, Leunig M, Ganz R. Magnetic resonance arthrography of the hip in femoroacetabular impingement: technique and findings. Oper Tech Orthop. 2005;15:191–203.CrossRef
22.
Zurück zum Zitat Wettstein M, Dienst M. [Hip arthroscopy for femoroacetabular impingement] [in German]. Orthopade. 2006;35:85–93.PubMedCrossRef Wettstein M, Dienst M. [Hip arthroscopy for femoroacetabular impingement] [in German]. Orthopade. 2006;35:85–93.PubMedCrossRef
Metadaten
Titel
Hip Capsule Dimensions in Patients With Femoroacetabular Impingement: A Pilot Study
verfasst von
Jan Weidner, MD
Lorenz Büchler, MD
Martin Beck, MD
Publikationsdatum
01.12.2012
Verlag
Springer-Verlag
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 12/2012
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-012-2485-2

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