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Hip internal rotation is correlated to radiographic findings of cam femoroacetabular impingement in collegiate football players.
Arthroscopy 2012; 28(11):1661-70A

Abstract

PURPOSE

The objective of this study was to determine whether physical examinations (flexion-abduction-external rotation [FABER], impingement, range-of-motion profiles) could be used to detect the bony abnormalities of femoroacetabular impingement (FAI) in an athletic population.

METHODS

We performed a prospective study of 65 male collegiate football players. Both hips were evaluated by 2 orthopaedic surgeons for radiographic signs of FAI. The alpha angle and head-neck offset were measured on frog-leg lateral films. The center-edge angle, acetabular index, crossover sign, and alpha angle were measured on anteroposterior films. Measurements were averaged for both observers. Maximum hip range of motion in flexion (supine) and internal/external rotation (supine, sitting, and prone) was measured with a goniometer. Pain provoked by the impingement and FABER tests was also recorded. Examinations were completed at 2 of 4 stations (2 duplicates), each staffed by 2 clinicians (1 examined and 1 measured). The relation between each range-of-motion and radiographic measure was determined. Data from each station were assessed separately. Only those regressions significant (P < .05) for paired stations were considered clinically significant.

RESULTS

The alpha angle and head-neck offset measured on the frog-leg lateral films were significantly correlated (all P < .01) to supine, sitting, and prone internal rotation for all stations. Correlation coefficients ranged from -0.59 to -0.35 for alpha angle and 0.42 to 0.57 for head-neck offset. Although 95% of the hips had at least 1 radiographic sign of FAI, pain was reported in only 8.5% and 2.3% during the impingement and FABER tests, respectively.

CONCLUSIONS

Internal rotation correlates to radiographic measures of cam FAI in this cohort of collegiate football players. Football players with diminished internal rotation in whom hip pain develops should be evaluated for underlying cam FAI abnormalities.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

Authors+Show Affiliations

Department of Bioengineering, University of Utah, Salt Lake City, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22999076

Citation

Kapron, Ashley L., et al. "Hip Internal Rotation Is Correlated to Radiographic Findings of Cam Femoroacetabular Impingement in Collegiate Football Players." Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, vol. 28, no. 11, 2012, pp. 1661-70.
Kapron AL, Anderson AE, Peters CL, et al. Hip internal rotation is correlated to radiographic findings of cam femoroacetabular impingement in collegiate football players. Arthroscopy. 2012;28(11):1661-70.
Kapron, A. L., Anderson, A. E., Peters, C. L., Phillips, L. G., Stoddard, G. J., Petron, D. J., ... Aoki, S. K. (2012). Hip internal rotation is correlated to radiographic findings of cam femoroacetabular impingement in collegiate football players. Arthroscopy : the Journal of Arthroscopic & Related Surgery : Official Publication of the Arthroscopy Association of North America and the International Arthroscopy Association, 28(11), pp. 1661-70. doi:10.1016/j.arthro.2012.04.153.
Kapron AL, et al. Hip Internal Rotation Is Correlated to Radiographic Findings of Cam Femoroacetabular Impingement in Collegiate Football Players. Arthroscopy. 2012;28(11):1661-70. PubMed PMID: 22999076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hip internal rotation is correlated to radiographic findings of cam femoroacetabular impingement in collegiate football players. AU - Kapron,Ashley L, AU - Anderson,Andrew E, AU - Peters,Christopher L, AU - Phillips,Lee G, AU - Stoddard,Gregory J, AU - Petron,David J, AU - Toth,Robert, AU - Aoki,Stephen K, Y1 - 2012/09/19/ PY - 2011/10/28/received PY - 2012/04/26/revised PY - 2012/04/26/accepted PY - 2012/9/25/entrez PY - 2012/9/25/pubmed PY - 2013/5/2/medline SP - 1661 EP - 70 JF - Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the International Arthroscopy Association JO - Arthroscopy VL - 28 IS - 11 N2 - PURPOSE: The objective of this study was to determine whether physical examinations (flexion-abduction-external rotation [FABER], impingement, range-of-motion profiles) could be used to detect the bony abnormalities of femoroacetabular impingement (FAI) in an athletic population. METHODS: We performed a prospective study of 65 male collegiate football players. Both hips were evaluated by 2 orthopaedic surgeons for radiographic signs of FAI. The alpha angle and head-neck offset were measured on frog-leg lateral films. The center-edge angle, acetabular index, crossover sign, and alpha angle were measured on anteroposterior films. Measurements were averaged for both observers. Maximum hip range of motion in flexion (supine) and internal/external rotation (supine, sitting, and prone) was measured with a goniometer. Pain provoked by the impingement and FABER tests was also recorded. Examinations were completed at 2 of 4 stations (2 duplicates), each staffed by 2 clinicians (1 examined and 1 measured). The relation between each range-of-motion and radiographic measure was determined. Data from each station were assessed separately. Only those regressions significant (P < .05) for paired stations were considered clinically significant. RESULTS: The alpha angle and head-neck offset measured on the frog-leg lateral films were significantly correlated (all P < .01) to supine, sitting, and prone internal rotation for all stations. Correlation coefficients ranged from -0.59 to -0.35 for alpha angle and 0.42 to 0.57 for head-neck offset. Although 95% of the hips had at least 1 radiographic sign of FAI, pain was reported in only 8.5% and 2.3% during the impingement and FABER tests, respectively. CONCLUSIONS: Internal rotation correlates to radiographic measures of cam FAI in this cohort of collegiate football players. Football players with diminished internal rotation in whom hip pain develops should be evaluated for underlying cam FAI abnormalities. LEVEL OF EVIDENCE: Level IV, therapeutic case series. SN - 1526-3231 UR - https://www.unboundmedicine.com/medline/citation/22999076/Hip_internal_rotation_is_correlated_to_radiographic_findings_of_cam_femoroacetabular_impingement_in_collegiate_football_players_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0749-8063(12)00484-7 DB - PRIME DP - Unbound Medicine ER -