The Effect of Cam FAI on Hip and Pelvic Motion during Maximum Squat
Tóm tắt
Femoroacetabular impingement (FAI) causes abnormal contact at the anterosuperior aspect of the acetabulum in activities requiring a large hip range of motion (ROM). We addressed the following questions in this study: (1) Does FAI affect the motions of the hip and pelvis during a maximal depth squat? (2) Does FAI decrease maximal normalized squat depth? We measured the effect of cam FAI on the 3-D motion of the hip and pelvis during a maximal depth squat as compared with a healthy control group. Fifteen participants diagnosed with cam FAI and 11 matched control participants performed unloaded squats while 3-D motion analysis was collected. Patients with FAI had no differences in hip motion during squatting but had decreased sagittal pelvic range of motion compared to the control group (14.7 ± 8.4° versus 24.2 ± 6.8°, respectively). The FAI group also could not squat as low as the control group (41.5 ± 12.5% versus 32.3 ± 6.8% of leg length, respectively), indicating the maximal depth squat may be useful as a diagnostic exercise. Limited sagittal pelvic ROM in FAI patients may contribute to their decreased squatting depth, and could represent a factor amongst others in the pathomechanics of FAI.
Level of Evidence: Level III, therapeutic study. See the Guidelines for Authors for a complete description of levels of evidence.
Tài liệu tham khảo
Beaule PE, Le Duff MJ, Zaragoza E. Quality of life following femoral head-neck osteochondroplasty for femoroacetabular impingement. J Bone Joint Surg Am. 2007;89:773–779.
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.
Bellamy N, Buchanan WW, Goldsmith CH, Campbell J, Stitt LW. Validation study of WOMAC: a health status instrument for measuring clinically important patient relevant outcomes to antirheumatic drug therapy in patients with osteoarthritis of the hip or knee. J Rheumatol. 1988;15:1833–1840.
Crawford JR, Villar RN. Current concepts in the management of femoroacetabular impingement. J Bone Joint Surg Br. 2005;87:1459–1462.
Davis RB, Ounpuu S, Tyburski D, Gage JR. A gait analysis data collection and reduction technique. Hum Mov Sci. 1991;10:575–587.
Della Croce U, Leardini A, Chiari L, Cappozzo A. Human movement analysis using stereophotogrammetry. Part 4: assessment of anatomical landmark misplacement and its effects on joint kinematics. Gait Posture. 2005;21:226–237.
Eijer H, Myers SR, Ganz R. Anterior femoroacetabular impingement after femoral neck fractures. J Orthop Trauma. 2001;15:475–481.
Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.
Flanagan S, Salem GJ, Wang MY, Sanker SE, Greendale GA. Squatting exercises in older adults: kinematic and kinetic comparisons. Med Sci Sports Exerc. 2003;35:635–643.
Ganz R, Parvizi J, Beck M, Leunig M, Notzli H, Siebenrock KA. Femoroacetabular impingement: a cause for osteoarthritis of the hip. Clin Orthop Relat Res. 2003:112–120.
Goodman DA, Feighan JE, Smith AD, Latimer B, Buly RL, Cooperman DR. Subclinical slipped capital femoral epiphysis. Relationship to osteoarthrosis of the hip. J Bone Joint Surg Am. 1997;79:1489–1497.
Harris WH. Etiology of osteoarthritis of the hip. Clin Orthop Relat Res. 1986:20–33.
Isear JA, Jr., Erickson JC, Worrell TW. EMG analysis of lower extremity muscle recruitment patterns during an unloaded squat. Med Sci Sports Exerc. 1997;29:532–539.
Ito K, Leunig M, Ganz R. Histopathologic features of the acetabular labrum in femoroacetabular impingement. Clin Orthop Relat Res. 2004:262–271.
Ito K, Minka MA, 2nd, Leunig M, Werlen S, Ganz R. Femoroacetabular impingement and the cam-effect. A MRI-based quantitative anatomical study of the femoral head-neck offset. J Bone Joint Surg Br. 2001;83:171–176.
Kadaba MP, Ramakrishnan HK, Wootten ME. Measurement of lower extremity kinematics during level walking. J Orthop Res. 1990;8:383–392.
Kadaba MP, Ramakrishnan HK, Wootten ME, Gainey J, Gorton G, Cochran GV. Repeatability of kinematic, kinetic, and electromyographic data in normal adult gait. J Orthop Res. 1989;7:849–860.
Kassarjian A, Brisson M, Palmer WE. Femoroacetabular impingement. Eur J Radiol. 2007;63:29–35.
Konishi N, Mieno T. Determination of acetabular coverage of the femoral head with use of a single anteroposterior radiograph. A new computerized technique. J Bone Joint Surg Am. 1993;75:1318–1333.
Kubiak-Langer M, Tannast M, Murphy SB, Siebenrock KA, Langlotz F. Range of motion in anterior femoroacetabular impingement. Clin Orthop Relat Res. 2007;458:117–124.
Laude F, Boyer T, Nogier A. Anterior femoroacetabular impingement. Joint Bone Spine. 2007;74:127–132.
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. 2004:61–66.
Leardini A, Chiari L, Della Croce U, Cappozzo A. Human movement analysis using stereophotogrammetry. Part 3. Soft tissue artifact assessment and compensation. Gait Posture. 2005;21:212–225.
Leunig M, Beck M, Kalhor M, Kim YJ, Werlen S, Ganz R. Fibrocystic changes at anterosuperior femoral neck: prevalence in hips with femoroacetabular impingement. Radiology. 2005;236:237–246.
Leunig M, Casillas MM, Hamlet M, Hersche O, Notzli H, Slongo T, Ganz R. Slipped capital femoral epiphysis: early mechanical damage to the acetabular cartilage by a prominent femoral metaphysis. Acta Orthop Scand. 2000;71:370–375.
Mardones RM, Gonzalez C, Chen Q, Zobitz M, Kaufman KR, Trousdale RT. Surgical treatment of femoroacetabular impingement: evaluation of the effect of the size of the resection. J Bone Joint Surg Am. 2005;87:273–279.
Meyer DC, Beck M, Ellis T, Ganz R, Leunig M. Comparison of six radiographic projections to assess femoral head/neck asphericity. Clin Orthop Relat Res. 2006;445:181–185.
Murray RO, Duncan C. Athletic activity in adolescence as an etiological factor in degenerative hip disease. J Bone Joint Surg Br. 1971;53:406–419.
Myers SR, Eijer H, Ganz R. Anterior femoroacetabular impingement after periacetabular osteotomy. Clin Orthop Relat Res. 1999:93–99.
Notzli HP, Wyss TF, Stoecklin CH, Schmid MR, Treiber K, Hodler J. The contour of the femoral head-neck junction as a predictor for the risk of anterior impingement. J Bone Joint Surg Br. 2002;84:556–560.
Pai YC, Rogers MW. Speed variation and resultant joint torques during sit-to-stand. Arch Phys Med Rehabil. 1991;72:881–885.
Philippon MJ, Maxwell RB, Johnston TL, Schenker M, Briggs KK. Clinical presentation of femoroacetabular impingement. Knee Surg Sports Traumatol Arthrosc. 2007;15:1041–1047.
Reinschmidt C, van den Bogert AJ, Nigg BM, Lundberg A, Murphy N. Effect of skin movement on the analysis of skeletal knee joint motion during running. J Biomech. 1997;30:729–732.
Reynolds D, Lucas J, Klaue K. Retroversion of the acetabulum. A cause of hip pain. J Bone Joint Surg Br. 1999;81:281–288.
Siebenrock KA, Kalbermatten DF, Ganz R. Effect of pelvic tilt on acetabular retroversion: a study of pelves from cadavers. Clin Orthop Relat Res. 2003:241–248.
Siebenrock KA, Schoeniger R, Ganz R. Anterior femoro-acetabular impingement due to acetabular retroversion. Treatment with periacetabular osteotomy. J Bone Joint Surg Am. 2003;85:278–286.
Tannast M, Kubiak-Langer M, Langlotz F, Puls M, Murphy SB, Siebenrock KA. Noninvasive three-dimensional assessment of femoroacetabular impingement. J Orthop Res. 2007;25:122–131.
Tanzer M, Noiseux N. Osseous abnormalities and early osteoarthritis: the role of hip impingement. Clin Orthop Relat Res. 2004;429:170–177.
Wagner S, Hofstetter W, Chiquet M, Mainil-Varlet P, Stauffer E, Ganz R, Siebenrock KA. Early osteoarthritic changes of human femoral head cartilage subsequent to femoro-acetabular impingement. Osteoarthritis Cartilage. 2003;11:508–518.
Wisniewski SJ, Grogg B. Femoroacetabular impingement: an overlooked cause of hip pain. Am J Phys Med Rehabil. 2006;85:546–549.
Wyss TF, Clark JM, Weishaupt D, Notzli HP. Correlation between internal rotation and bony anatomy in the hip. Clin Orthop Relat Res. 2007;460:152–158.
Zebala LP, Schoenecker PL, Clohisy JC. Anterior femoroacetabular impingement: a diverse disease with evolving treatment options. Iowa Orthop J. 2007;27:71–81.