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BMC Musculoskelet Disord. 2017 Oct 16;18(1):417. doi: 10.1186/s12891-017-1778-8.

Comparison of improved range of motion between cam-type femoroacetabular impingement and borderline developmental dysplasia of the hip -evaluation by virtual osteochondroplasty using computer simulation.

Author information

1
Department of Orthopaedic Surgery, Yokohama City University, 3-9Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan.
2
Department of Orthopaedic Surgery, Yokohama City University, 3-9Fukuura, Kanazawa-ku, Yokohama, Kanagawa, 236-0004, Japan. yute0131@med.yokohama-cu.ac.jp.

Abstract

BACKGROUND:

While cam resection is essential to achieve a good clinical result with respect to femoroacetabular impingement (FAI), it is unclear whether it should also be performed in cases of borderline developmental dysplasia of the hip (DDH) with a cam deformity. The aim of this study was to evaluate improvements in range of motion (ROM) in cases of cam-type FAI and borderline DDH after virtual osteochondroplasty using a computer impingement simulation.

METHODS:

Thirty-eight symptomatic hips in 31 patients (11male and 20 female) diagnosed with cam-type FAI or borderline DDH were analyzed. There were divided into a cam-type FAI group (cam-FAI group: 15 hips), borderline DDH without cam group (DDH W/O cam group: 12 hips), and borderline DDH with cam group (DDH W/ cam group: 11 hips). The bony impingement point on the femoral head-neck junction at 90° flexion and maximum internal rotation of the hip joint was identified using ZedHip® software. Virtual osteochondroplasty of the impingement point was then performed in all cases. The maximum flexion angle and maximum internal rotation angle at 90° flexion were measured before and after virtual osteochondroplasty at two resection ranges (i.e., slight and sufficient).

RESULTS:

The mean improvement in the internal rotation angle in the DDH W/ cam group after slight resection was significantly greater than that in the DDH W/O cam group (P = 0.046). Furthermore, the mean improvement in the internal rotation angle in the DDH W/ cam and cam-FAI groups after sufficient resection was significantly greater than that in the DDH W/O cam group (DDH W/ cam vs DDH W/O cam: P = 0.002, cam-FAI vs DDH W/O cam: P = 0.043).

CONCLUSION:

Virtual osteochondroplasty resulted in a significant improvement in internal rotation angle in DDH W/ cam group but not in DDH W/O cam group. Thus, borderline DDH cases with cam deformity may be better to consider performing osteochondroplasty.

KEYWORDS:

Borderline developmental dysplasia of the hip; Femoroacetabular impingement; Impingement simulation; Range of motion

PMID:
29037180
PMCID:
PMC5644060
DOI:
10.1186/s12891-017-1778-8
[Indexed for MEDLINE]
Free PMC Article

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