Hip

OBJECTIVES: Determine the association between hip abduction strength and lower extremity running related injury in distance runners. DESIGN: Systematic review. METHODS: Prospective longitudinal and cross sectional studies that quantified hip abduction strength and provided diagnosis of running related injury in distance runners were included and assessed for quality. Effect size was calculated for between group differences in hip abduction strength...

BACKGROUND: Athletic groin pain (AGP) is prevalent in sports involving repeated accelerations, decelerations, kicking and change-of-direction movements. Clinical and radiological examinations lack the ability to assess pathomechanics of AGP, but three-dimensional biomechanical movement analysis may be an important innovation. AIM: The primary aim was to describe and analyse movements used by patients with AGP during a maximum effort change-of-direction task. The secondary aim was to determine if specific anatomical diagnoses were related to a distinct movement strategy...

PURPOSE: To report on patterns of clinical presentation, intra-articular derangements, radiological associations, and minimum 2-year outcomes after hip arthroscopy (HA) in patients 18 years or younger. METHODS: This study was a retrospective case series on patients 18 years or younger who had undergone HA for labral tears that had failed nonoperative management from April 2008 to April 2013 with a minimum 2-year follow-up. Exclusion criteria were previous hip conditions or surgery...

Cam morphology of the proximal femur is an abnormal contour of the femoral head-neck junction present in approximately 15% to 25% of the asymptomatic population, predominantly in males. Alpha angle and femoral head-neck offset ratio are 2 objective measurement tools that define cam morphology. Both primary (idiopathic) and secondary cam deformity develops through distinct mechanisms. The cause of primary (idiopathic) cam morphology remains incompletely understood. Mounting evidence suggests that idiopathic cam morphology develops during adolescence through alterations in the capital femoral epiphysis in response to participation in vigorous sporting activity...

PURPOSE: To evaluate femoral head-neck bone regrowth and PROs in skeletally immature patients that underwent arthroscopic femoroplasties over a minimum 2-year period. METHODS: Eleven skeletally immature hips (10 patients) with open femoral head physes underwent femoroplasty between October 2008 and November 2013. Inclusion criteria were minimum 2-year follow-up with patient-reported outcomes (PROs) and radiographs preoperatively, at 2 weeks, and at a minimum of 2 years postoperatively...

PURPOSE: To identify major and minor complication rates associated with hip arthroscopy from a payer-based national database and compare with the rates reported in the existing literature. METHODS: Patients who underwent hip arthroscopy between 2007 and 2014 were identified using PearlDiver, a publicly available database. Rates of major and minor complications, as well as conversion to total hip arthroscopy (THA), were determined by using Current Procedural Terminology (CPT) and International Classification of Diseases, Ninth Revision (ICD-9), codes...

The 21 muscles that cross the hip provide both triplanar movement and stability between the femur and acetabulum. The primary intent of this clinical commentary is to review and discuss the current understanding of the specific actions of the hip muscles. Analysis of their actions is based primarily on the spatial orientation of the muscles relative to the axes of rotation at the hip. The discussion of muscle actions is organized according to the 3 cardinal planes of motion. Actions are considered from both femoral-on-pelvic and pelvic-on-femoral perspectives, with particular attention to the role of coactivation of trunk muscles...

The hip is a complex anatomic structure composed of osseous, ligamentous, and muscular structures responsible for transferring the weight of the body from the axial skeleton into the lower extremities. This must be accomplished while allowing for dynamic loading during activities such as gait and balance. The evaluation of hip pain and periarticular pathology can be challenging because of the complex local anatomy and broad differential diagnosis. Recent advancements in the evaluation and surgical treatment of hip pathology have led to a renewed interest in the management of these disorders...

The primary purpose of this review article is to discuss the role of diagnostic, corticosteroid, hyaluronic acid (HA) and platelet rich plasma (PRP) in the treatment of osteoarthritis (OA) and femoroacetabular impingement (FIA). These treatments play an important biological role in the non-operative management of these conditions. Two independent reviewers performed an search of PubMed for articles that contained at least one of the following search terms pertaining to intra-articular hip injection-local anaesthetic, diagnostic, ultrasound, fluoroscopic, image guided, corticosteroid, HA, PRP, OA, labral tears and FAI...

PURPOSE: To critically evaluate the evidence for arthroscopic management of chondral defects in the hip through a systematic literature review. METHODS: A systematic literature review was performed to identify all articles addressing the arthroscopic management of chondral defects about the hip. Case reports, open techniques, and those associated with osteonecrosis were excluded. Articles were assessed for sample size, location, severity, and size of chondral defects, and the surgical technique...

BACKGROUND: Recent studies have questioned the importance of the iliotibial band (ITB) in lateral knee pain. The Ober test or modified Ober test is the most commonly recommended physical examination tool for assessment of ITB tightness. No studies support the validity of either Ober test for measuring ITB tightness. PURPOSE/HYPOTHESIS: The purpose of this study was to assess the effects of progressive transection of the ITB, gluteus medius and minimus (med/min) muscles, and hip joint capsule of lightly embalmed cadavers on Ober test results and to compare them with assessment of all structures intact...

BACKGROUND: The anatomy of the acetabulum has been described extensively in the literature, but radiographic acetabular guidelines have not been well established. This study provides a radiographic map of acetabular landmarks in the hip. PURPOSE/HYPOTHESIS: The purpose of this study was to quantify the precise radiographic location of arthroscopic landmarks around the acetabulum. The hypothesis was that their locations were reproducible despite variability in the anatomy and positioning of pelvic specimens...

BACKGROUND: Prospective studies have reported that abnormal movement patterns at the trunk, hip, and knee are associated with noncontact anterior cruciate ligament (ACL) injuries. Impaired hip strength may underlie these abnormal movement patterns, suggesting that diminished hip strength may increase the risk of noncontact ACL injury. PURPOSE: To determine whether baseline hip strength predicts future noncontact ACL injury in athletes. STUDY DESIGN: Case-control study; Level of evidence, 3...

The surgical management of symptomatic femoroacetabular impingement (FAI) generally is indicated after the failure of a trial of nonsurgical treatment. Surgical planning includes an assessment of the labrochondral pathology as well as of the acetabular and proximal femoral bony deformity. Advanced articular cartilage disease generally is associated with poorer outcomes. Surgical hip dislocation and hip arthroscopy have been used, with favorable early outcomes and low complication rates. Careful patient selection is important in predicting the success of the surgical management of symptomatic FAI...

Imaging studies play a key role in establishing the diagnosis of femoroacetabular impingement (FAI). When clinical examination is suggestive of FAI, radiographic evidence should confirm the diagnosis. Imaging findings must be evaluated in the context of the patient's clinical presentation and recreational activities. Plain radiographic evaluation remains the initial diagnostic modality. Three-dimensional imaging such as MRI and CT often is obtained for the evaluation of labral and cartilage pathology, definition of bony anatomy, and surgical planning...

STUDY DESIGN: Controlled laboratory study, cross-sectional. Objectives To characterize hip muscle forces and powers during running, and to determine how these quantities change when altering step rate for a given running speed. BACKGROUND: Hip musculature has been implicated in a variety of running-related injuries and, as such, is often the target of rehabilitation interventions, including resistance exercises and gait retraining. The differential contributions of the hip muscles to the task of running are not well understood, and may be important for recognizing the biomechanical mechanisms of running-related injuries and refining current treatment and prevention strategies...

STUDY DESIGN: Controlled laboratory cross-sectional study. Objectives To assess strength differences of the hip rotator and abductor muscle groups in young adults with chronic hip joint pain (CHJP) and asymptomatic controls. A secondary objective was to determine if strength in the uninvolved hip of those with unilateral CHJP differs from that in asymptomatic controls. BACKGROUND: Little is known about the relationship between hip muscle strength and CHJP in young adults...

BACKGROUND: Impaired hip muscle performance has been implicated as a contributing factor to the increased risk of anterior cruciate ligament (ACL) injury in women. PURPOSE: To determine the influence of a hip-focused training program on lower extremity biomechanics during a drop-jump task. STUDY DESIGN: Descriptive laboratory study. METHODS: Twenty-one recreationally active women (18-25 years of age) participated in a 4-week training program consisting of hip-focused plyometric and balance perturbation exercises (3 times/wk, 30 min/session)...

A comprehensive knowledge of normal hip anatomy and imaging techniques is essential in the evaluation and assessment of the patient with hip pain. This article reviews the osseous, soft tissue, and vascular components of the hip and the normal anatomical variants encountered in routine hip imaging. Basic and advanced hip imaging is discussed with particular emphasis on radiographic and computed tomography measurements and their utility in evaluating patients with developmental hip dysplasia and femoroacetabular impingement syndrome...

BACKGROUND: Radiographic features specifically related to the occurrence of femoroacetabular impingement (FAI) appear to be highly prevalent in the asymptomatic population. It remains unclear, however, how these incidental findings should be interpreted clinically and which other variables might differentiate between true incidental findings and preclinical patients. PURPOSE: To study the association between cam and overall hip morphological characteristics and range of motion in impingement patients, asymptomatic patients (healthy patients with radiographic features specific to FAI), and healthy controls...