|Can the alpha angle assessment of cam impingement predict acetabular cartilage delamination?|
|PMID: 23001504 Owner: NLM Status: MEDLINE|
|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.
|Paul E Beaulé; Kelly Hynes; Gillian Parker; Kyle A Kemp|
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|Type: Journal Article|
|Title: Clinical orthopaedics and related research Volume: 470 ISSN: 1528-1132 ISO Abbreviation: Clin. Orthop. Relat. Res. Publication Date: 2012 Dec|
|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|
|Languages: eng Pagination: 3361-7 Citation Subset: AIM; IM|
|APA/MLA Format Download EndNote Download BibTex|
Cartilage, Articular / radiography*, surgery
Femoracetabular Impingement / complications, radiography*, surgery
Osteoarthritis, Hip / etiology, radiography
Predictive Value of Tests
Severity of Illness Index
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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