Document Detail

Femoroacetabular impingement predisposes to traumatic posterior hip dislocation.
MedLine Citation:
PMID:  23423625     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Traumatic posterior hip dislocation in adults is generally understood to be the result of a high-energy trauma. Aside from reduced femoral antetorsion, morphologic risk factors for dislocation are unknown. We previously noticed that some hips with traumatic posterior dislocations had evidence of morphologic features of femoroacetabular impingement (FAI), therefore, we sought to evaluate that possibility more formally.
QUESTIONS/PURPOSES: We asked whether hips with a traumatic posterior hip dislocation present with (1) a cam-type deformity and/or (2) a retroverted acetabulum.
METHODS: We retrospectively compared the morphologic features of 53 consecutive hips (53 patients) after traumatic posterior hip dislocation with 85 normal hips (44 patients) based on AP pelvic and crosstable axial radiographs. We measured the axial and the lateral alpha angle for detection of a cam deformity and the crossover sign, ischial spine sign, posterior wall sign, retroversion index, and ratio of anterior to posterior acetabular coverage to describe the acetabular orientation.
RESULTS: Hips with traumatic posterior traumatic dislocation were more likely to have cam deformities than were normal hips, in that the hips with dislocation had increased axial and lateral alpha angles. Hips with posterior dislocation also were more likely to be retroverted; dislocated hips had a higher prevalence of a positive crossover sign, ischial spine sign, and posterior wall sign, and they had a higher retroversion index and increased ratio of anterior to posterior acetabular coverage.
CONCLUSIONS: Hips with posterior traumatic dislocation typically present with morphologic features of anterior FAI, including a cam-type deformity and retroverted acetabulum. An explanation for these findings could be that the early interaction between the aspherical femoral head and the prominent acetabular rim acts as a fulcrum, perhaps making these hips more susceptible to traumatic dislocation.
Simon D Steppacher; Christoph E Albers; Klaus A Siebenrock; Moritz Tannast; Reinhold Ganz
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Publication Detail:
Type:  Journal Article     Date:  2013-02-20
Journal Detail:
Title:  Clinical orthopaedics and related research     Volume:  471     ISSN:  1528-1132     ISO Abbreviation:  Clin. Orthop. Relat. Res.     Publication Date:  2013 Jun 
Date Detail:
Created Date:  2013-05-02     Completed Date:  2013-06-25     Revised Date:  2014-06-03    
Medline Journal Info:
Nlm Unique ID:  0075674     Medline TA:  Clin Orthop Relat Res     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1937-43     Citation Subset:  AIM; IM    
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MeSH Terms
Acetabulum / pathology,  radiography
Bone Retroversion / diagnosis,  epidemiology*
Femoracetabular Impingement / diagnosis,  epidemiology*
Hip Dislocation / diagnosis,  epidemiology*
Hip Injuries / diagnosis,  epidemiology*
Hip Joint / pathology,  radiography
Middle Aged
Retrospective Studies
Switzerland / epidemiology
Trauma Severity Indices
Young Adult
Comment In:
Clin Orthop Relat Res. 2013 Jun;471(6):1944-5   [PMID:  23471554 ]
Clin Orthop Relat Res. 2013 Nov;471(11):3720-1   [PMID:  24014272 ]
Clin Orthop Relat Res. 2013 Nov;471(11):3718-9   [PMID:  24030625 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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