Purpose
(1) To estimate the frequency of subspine impingement (SSI) morphology in patients
with a diagnosis of femoroacetabular impingement (FAI) and (2) to describe the performance
of the alpha angle, range of motion, and femoral and acetabular anteversion for the
identification of cases with and without SSI morphology.
Methods
We performed a retrospective observational study of patients with symptomatic FAI
evaluated by computed tomography between February 2015 and June 2017. SSI morphology
was identified using a 3-dimensional dynamic study with Move Forward software. A case
was considered positive if a contact area of the anterior inferior iliac spine with
the femoral neck was evidenced. Measurements of acetabular anteversion, femoral anteversion,
the lateral center-edge angle, the alpha angle, and the neck-shaft angle, as well
as range-of-mobility data, were collected.
Results
The study included 135 patients (194 hips), with a mean age of 39.1 ± 13.9 years;
65.2% were women. SSI morphology was found in 23.7% of hips (46 hips) (95% confidence
interval, 18.3%-30.2%). Of the hips identified with SSI, 52.2% had a type I anterior
inferior iliac spine, 41.3% had type II, and 6.5% had type III. In hips with SSI,
median femoral anteversion was 5.6° (interquartile range, 2.1°-7.5°) and values of
less than 8° would increase the suspected SSI morphology (81.8% sensitivity, 70.5%
specificity).
Conclusions
SSI morphology is a frequent finding in patients with symptomatic FAI through a 3-dimensional
dynamic study. A decrease in femoral anteversion could be considered a useful criterion
to suspect SSI morphology.
Level of Evidence
Level IV, case series.
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Article info
Publication history
Accepted:
August 8,
2018
Received:
February 19,
2018
Footnotes
See commentary on page 97
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
Identification
Copyright
© 2018 by the Arthroscopy Association of North America
ScienceDirect
Access this article on ScienceDirectLinked Article
- Editorial Commentary: Subspine Hip Abnormalities: Exploring the Difference Between “Morphology” and “Impingement”ArthroscopyVol. 35Issue 1
- PreviewSubspine impingement has been increasingly recognized as a source of hip pain over the past 5 to 10 years. Some surgeons routinely perform subspine/anterior inferior iliac spine (AIIS) decompressions, whereas others rarely perform these procedures as part of an arthroscopic hip procedure. Subspine impingement has been implicated with high range-of-motion activities, various AIIS morphologies and deformities, and in the setting of persistent anterior hip pain after intra-articular anesthetic injections.
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