Document Detail


Can the alpha angle assessment of cam impingement predict acetabular cartilage delamination?
MedLine Citation:
PMID:  23001504     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Substantial acetabular cartilage damage is commonly present in patients suffering from femoral acetabular impingement (FAI). A better understanding of which patient is at risk of developing substantial cartilage damage is critical for establishing appropriate treatment guidelines.
QUESTIONS/PURPOSES: We asked: (1) Does the cam deformity severity in FAI as assessed by alpha angle predict acetabular cartilage delamination? And (2) what are the clinical and radiographic findings in patients with acetabular cartilage delamination?
METHODS: One hundred sixty-seven patients (129 males, 38 females) with a mean age of 38 years (range, 17-59 years) underwent joint preservation surgery for cam-type FAI. All data were collected prospectively. We assessed center-edge angle and Tönnis grade on AP radiographs and alpha angle on specialized lateral radiographs. Acetabular cartilage damage was assessed intraoperatively using the classification of Beck et al., with Type 3 and greater qualifying as delamination.
RESULTS: For all hips, mean alpha angle was 65.5° (range, 41°-90°), and mean center-edge angle was 33.3° (range, 21°-52.5°). Patients with an alpha angle of 65° or greater had an odds ratio (OR) of 4.00 (95% CI, 1.26-12.71) of having Type 3 or greater damage. Increased age (OR, 1.04; 95% CI, 1.01-1.07) and male sex (OR, 2.24; 95% CI, 1.09-4.62) were associated with Type 3 or greater damage, while this was the opposite for acetabular coverage as assessed by center-edge angle (OR, 0.94; 95% CI, 0.89-0.99).
CONCLUSIONS: Patients with cam-type FAI and an alpha angle of 65° or more are at increased risk of substantial cartilage damage while increasing acetabular coverage appears to have a protective effect.
LEVEL OF EVIDENCE: Level III, prognostic study. See the Instructions for Authors for a complete description of levels of evidence.
Authors:
Paul E Beaulé; Kelly Hynes; Gillian Parker; Kyle A Kemp
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  470     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-08     Completed Date:  2013-01-22     Revised Date:  2013-12-04    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  3361-7     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acetabulum / radiography*,  surgery
Adolescent
Adult
Cartilage, Articular / radiography*,  surgery
Disease Progression
Female
Femoracetabular Impingement / complications,  radiography*,  surgery
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Odds Ratio
Osteoarthritis, Hip / etiology,  radiography
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Severity of Illness Index
Young Adult
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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