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Klaus Arno Siebenrock - One of the best experts on this subject based on the ideXlab platform.
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Femoroacetabular Impingement.
European journal of radiology, 2011Co-Authors: Suzanne E Anderson, Klaus Arno Siebenrock, Moritz TannastAbstract:Femoroacetabular Impingement (FAI) is a pathomechanical concept describing the early and painful contact of morphological changes of the hip joint, both on the acetabular, and femoral head sides. These can lead clinically to symptoms of hip and groin pain, and a limited range of motion with labral, chondral and bony lesions. Pincer Impingement generally involves the acetabular side of the joint where there is excessive coverage of the acetabulum, which may be focal or more diffuse. There is linear contact of the acetabulum with the head/neck junction. Cam Impingement involves the femoral head side of the joint where the head is associated with bony excrescences and is aspheric. The aspheric femoral head jams into the acetabulum. Imaging appearances are reviewed below. This type is evident in young males in the second and third decades. The main features of FAI are described.
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Hip Damage Occurs at the Zone of Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2008Co-Authors: Moritz Tannast, D Goricki, S B Murphy, Martin Beck, Klaus Arno SiebenrockAbstract:Although current concepts of anterior Femoroacetabular Impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type Femoroacetabular Impingement (Group I) with the locations of Femoroacetabular Impingement in 15 additional hips using computer simulation (Group II). We found no difference between the mean locations of the chondrolabral damage of Group I and the computed Impingement zone of Group II. The standard deviation was larger for measures of articular damage from Group I in comparison to the computed values of Group II. The most severe hip damage occurred at the zone of highest probability of Femoroacetabular impact, typically in the anterosuperior quadrant of the acetabulum for both cam and pincer type Femoroacetabular Impingements. However, the extent of joint damage along the acetabular rim was larger intraoperatively than that observed on the images of the 3-D joint simulations. We concluded Femoroacetabular Impingement mechanism contributes to early osteoarthritis including labral lesions. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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hip damage occurs at the zone of Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2008Co-Authors: Moritz Tannast, D Goricki, S B Murphy, Martin Beck, Klaus Arno SiebenrockAbstract:Although current concepts of anterior Femoroacetabular Impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type Femoroacetabular Impingement (Group I) with the locations of Femoroacetabular Impingement in 15 additional hips using computer simulation (Group II). We found no difference between the mean locations of the chondrolabral damage of Group I and the computed Impingement zone of Group II. The standard deviation was larger for measures of articular damage from Group I in comparison to the computed values of Group II. The most severe hip damage occurred at the zone of highest probability of Femoroacetabular impact, typically in the anterosuperior quadrant of the acetabulum for both cam and pincer type Femoroacetabular Impingements. However, the extent of joint damage along the acetabular rim was larger intraoperatively than that observed on the images of the 3-D joint simulations. We concluded Femoroacetabular Impingement mechanism contributes to early osteoarthritis including labral lesions.
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Femoroacetabular Impingement radiographic diagnosis what the radiologist should know
American Journal of Roentgenology, 2007Co-Authors: Moritz Tannast, Klaus Arno Siebenrock, Suzanne E AndersonAbstract:OBJECTIVE. The purpose of this article is to show the important radiographic criteria that indicate the two types of Femoroacetabular Impingement: pincer and cam Impingement. In addition, potential pitfalls in pelvic imaging concerning Femoroacetabular Impingement are shown.CONCLUSION. Femoroacetabular Impingement is a major cause for early “primary” osteoarthritis of the hip. It can easily be recognized on conventional radiographs of the pelvis and the proximal femur.
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Femoroacetabular Impingement: Radiographic Diagnosis—What the Radiologist Should Know
AJR. American journal of roentgenology, 2007Co-Authors: Moritz Tannast, Klaus Arno Siebenrock, Suzanne E AndersonAbstract:OBJECTIVE. The purpose of this article is to show the important radiographic criteria that indicate the two types of Femoroacetabular Impingement: pincer and cam Impingement. In addition, potential pitfalls in pelvic imaging concerning Femoroacetabular Impingement are shown.CONCLUSION. Femoroacetabular Impingement is a major cause for early “primary” osteoarthritis of the hip. It can easily be recognized on conventional radiographs of the pelvis and the proximal femur.
Moritz Tannast - One of the best experts on this subject based on the ideXlab platform.
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Femoroacetabular Impingement.
European journal of radiology, 2011Co-Authors: Suzanne E Anderson, Klaus Arno Siebenrock, Moritz TannastAbstract:Femoroacetabular Impingement (FAI) is a pathomechanical concept describing the early and painful contact of morphological changes of the hip joint, both on the acetabular, and femoral head sides. These can lead clinically to symptoms of hip and groin pain, and a limited range of motion with labral, chondral and bony lesions. Pincer Impingement generally involves the acetabular side of the joint where there is excessive coverage of the acetabulum, which may be focal or more diffuse. There is linear contact of the acetabulum with the head/neck junction. Cam Impingement involves the femoral head side of the joint where the head is associated with bony excrescences and is aspheric. The aspheric femoral head jams into the acetabulum. Imaging appearances are reviewed below. This type is evident in young males in the second and third decades. The main features of FAI are described.
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Hip Damage Occurs at the Zone of Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2008Co-Authors: Moritz Tannast, D Goricki, S B Murphy, Martin Beck, Klaus Arno SiebenrockAbstract:Although current concepts of anterior Femoroacetabular Impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type Femoroacetabular Impingement (Group I) with the locations of Femoroacetabular Impingement in 15 additional hips using computer simulation (Group II). We found no difference between the mean locations of the chondrolabral damage of Group I and the computed Impingement zone of Group II. The standard deviation was larger for measures of articular damage from Group I in comparison to the computed values of Group II. The most severe hip damage occurred at the zone of highest probability of Femoroacetabular impact, typically in the anterosuperior quadrant of the acetabulum for both cam and pincer type Femoroacetabular Impingements. However, the extent of joint damage along the acetabular rim was larger intraoperatively than that observed on the images of the 3-D joint simulations. We concluded Femoroacetabular Impingement mechanism contributes to early osteoarthritis including labral lesions. Level of Evidence: Level II, diagnostic study. See the Guidelines for Authors for a complete description of levels of evidence.
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hip damage occurs at the zone of Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2008Co-Authors: Moritz Tannast, D Goricki, S B Murphy, Martin Beck, Klaus Arno SiebenrockAbstract:Although current concepts of anterior Femoroacetabular Impingement predict damage in the labrum and the cartilage, the actual joint damage has not been verified by computer simulation. We retrospectively compared the intraoperative locations of labral and cartilage damage of 40 hips during surgical dislocation for cam or pincer type Femoroacetabular Impingement (Group I) with the locations of Femoroacetabular Impingement in 15 additional hips using computer simulation (Group II). We found no difference between the mean locations of the chondrolabral damage of Group I and the computed Impingement zone of Group II. The standard deviation was larger for measures of articular damage from Group I in comparison to the computed values of Group II. The most severe hip damage occurred at the zone of highest probability of Femoroacetabular impact, typically in the anterosuperior quadrant of the acetabulum for both cam and pincer type Femoroacetabular Impingements. However, the extent of joint damage along the acetabular rim was larger intraoperatively than that observed on the images of the 3-D joint simulations. We concluded Femoroacetabular Impingement mechanism contributes to early osteoarthritis including labral lesions.
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Femoroacetabular Impingement radiographic diagnosis what the radiologist should know
American Journal of Roentgenology, 2007Co-Authors: Moritz Tannast, Klaus Arno Siebenrock, Suzanne E AndersonAbstract:OBJECTIVE. The purpose of this article is to show the important radiographic criteria that indicate the two types of Femoroacetabular Impingement: pincer and cam Impingement. In addition, potential pitfalls in pelvic imaging concerning Femoroacetabular Impingement are shown.CONCLUSION. Femoroacetabular Impingement is a major cause for early “primary” osteoarthritis of the hip. It can easily be recognized on conventional radiographs of the pelvis and the proximal femur.
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Femoroacetabular Impingement: Radiographic Diagnosis—What the Radiologist Should Know
AJR. American journal of roentgenology, 2007Co-Authors: Moritz Tannast, Klaus Arno Siebenrock, Suzanne E AndersonAbstract:OBJECTIVE. The purpose of this article is to show the important radiographic criteria that indicate the two types of Femoroacetabular Impingement: pincer and cam Impingement. In addition, potential pitfalls in pelvic imaging concerning Femoroacetabular Impingement are shown.CONCLUSION. Femoroacetabular Impingement is a major cause for early “primary” osteoarthritis of the hip. It can easily be recognized on conventional radiographs of the pelvis and the proximal femur.
Javad Parvizi - One of the best experts on this subject based on the ideXlab platform.
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Femoroacetabular Impingement.
The Journal of the American Academy of Orthopaedic Surgeons, 2007Co-Authors: Javad Parvizi, Michael Leunig, Reinhold GanzAbstract:Evidence is emerging that subtle morphologic abnormalities around the hip, resulting in Femoroacetabular Impingement, may be a contributing factor in some instances to osteoarthritis in the young patient. The morphologic abnormalities result in abnormal contact between the femoral neck/head and the acetabular margin, causing tearing of the labrum and avulsion of the underlying cartilage region, continued deterioration, and eventual onset of arthritis. Nonsurgical treatment typically fails to control symptoms. Surgical management involves dislocation of the hip (while preserving the blood supply to the femoral head) and Femoroacetabular osteoplasty. Encouraging results have been reported following Femoroacetabular osteoplasty and arthroscopic treatment of Femoroacetabular Impingement.
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Hip pain in young adults: Femoroacetabular Impingement.
The Journal of Arthroplasty, 2007Co-Authors: Fereidoon Mojtahed Jaberi, Javad ParviziAbstract:Femoroacetabular Impingement is a more recently noticed cause of hip pain in young patients, and early diagnosis and treatment are critical to prevent development of osteoarthritis and/or delay the need for a more radical treatment option such as arthroplasty surgery. Two general types of Femoroacetabular Impingement have been described. In the cam Impingement, the femoral deformity, usually a bump on the head-and-neck junction, impinges on the acetabular rim. The pincer type of Impingement is caused by the deformity on the acetabular side, which may be a deep socket, or an acetabular overcoverage due to retroversion that creates an obstacle for flexion and internal rotation. This article attempts to examine the underlying pathogenesis and discusses diagnostic and treatment modalities.
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Femoroacetabular Impingement.
Seminars in musculoskeletal radiology, 2007Co-Authors: Luis Pulido, Javad ParviziAbstract:Arthritis of the hip is a common cause of chronic disability. Although traditionally perceived as a condition occurring in the elderly, the detection of early hip arthritis in the young population must not be overlooked. The detection of subtle anatomical abnormalities giving rise to hip pain continues to pose a challenge. Recently, Femoroacetabular Impingement has been recognized as an etiological risk factor for early arthritis and hip pain in the young adult. The recent advances in imaging technology and the potential for joint-preserving surgical procedures allow early diagnosis and potentially better delivery of care to these patients. It is hence imperative that all those in the musculoskeletal community involved in the management of these young patients be familiar with this relatively common condition.
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anterior Femoroacetabular Impingement part i techniques of joint preserving surgery
Clinical Orthopaedics and Related Research, 2004Co-Authors: Martin Lavigne, Martin Beck, Reinhold Ganz, Klaus Arno Siebenrock, Javad Parvizi, Michael LeunigAbstract:The exact pathomechanism responsible for osteoarthritis (OA) of the nondysplastic hip has remained unknown for many years. There is, however, emerging clinical evidence implicating Femoroacetabular Impingement as an etiologic factor for having early OA of the hip develop. Femoroacetabular Impingement is an abutment conflict occurring between the proximal femur and the acetabular rim arising from morphologic abnormalities affecting the acetabulum or the proximal femur, or both. The repetitive mechanical conflict occurring during motion, particularly flexion and internal rotation, can lead to lesions of acetabular labrum and, even more serious, the adjacent acetabular cartilage. Surgical treatment of Femoroacetabular Impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. We will describe the rationale for the treatment of this condition, and discuss the technique of joint-preserving surgery.
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Femoroacetabular Impingement a cause for osteoarthritis of the hip
Clinical Orthopaedics and Related Research, 2003Co-Authors: Reinhold Ganz, Martin Beck, Michael Leunig, Javad Parvizi, Hubert Notzli, Klaus Arno SiebenrockAbstract:A multitude of factors including biochemical, genetic, and acquired abnormalities may contribute to osteoarthritis of the hip. Although the pathomechanism of the degenerative process affecting the dysplastic hip is well understood, the exact pathogenesis for idiopathic osteoarthritis has not been established. Based on clinical experience, with more than 600 surgical dislocations of the hip, allowing in situ inspection of the damage pattern and the dynamic proof of its origin, we propose Femoroacetabular Impingement as a mechanism for the development of early osteoarthritis for most nondysplastic hips. The concept focuses more on motion than on axial loading of the hip. Distinct clinical, radiographic, and intraoperative parameters can be used to confirm the diagnosis of this entity with timely delivery of treatment. Surgical treatment of Femoroacetabular Impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. It is proposed that early surgical intervention for treatment of Femoroacetabular Impingement, besides providing relief of symptoms, may decelerate the progression of the degenerative process for this group of young patients.
Reinhold Ganz - One of the best experts on this subject based on the ideXlab platform.
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The history of Femoroacetabular Impingement.
Bone & joint research, 2020Co-Authors: Kenki Matsumoto, Reinhold Ganz, Vikas KhandujaAbstract:Aims Femoroacetabular Impingement (FAI) describes abnormal bony contact of the proximal femur against the acetabulum. The term was first coined in 1999; however what is often overlooked is that des...
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arthroscopic management of Femoroacetabular Impingement osteoplasty technique and literature review
American Journal of Sports Medicine, 2007Co-Authors: Marc J Philippon, Brian R Maxwell, Allston J. Stubbs, Reinhold Ganz, Mara L Schenker, Michael LeunigAbstract:Morphological and spatial abnormalities of the proximal femur and acetabulum have been recently recognized as causes of Femoroacetabular Impingement. During joint motion in hips with Femoroacetabular Impingement, abnormal bony contact occurs, and soft tissue structures (chondral and labral) often fail. Femoroacetabular Impingement has been reported to be a contributor to early-onset joint degeneration. Ganz et al have described good midterm success with an open surgical dislocation approach to reconstruct normal joint clearance. The purpose of this report is to discuss relevant literature and describe an arthroscopic approach to treat Femoroacetabular Impingement. This approach has particular relevance in high-demand patients, particularly in athletes seeking to return to high-level sport.
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Femoroacetabular Impingement.
The Journal of the American Academy of Orthopaedic Surgeons, 2007Co-Authors: Javad Parvizi, Michael Leunig, Reinhold GanzAbstract:Evidence is emerging that subtle morphologic abnormalities around the hip, resulting in Femoroacetabular Impingement, may be a contributing factor in some instances to osteoarthritis in the young patient. The morphologic abnormalities result in abnormal contact between the femoral neck/head and the acetabular margin, causing tearing of the labrum and avulsion of the underlying cartilage region, continued deterioration, and eventual onset of arthritis. Nonsurgical treatment typically fails to control symptoms. Surgical management involves dislocation of the hip (while preserving the blood supply to the femoral head) and Femoroacetabular osteoplasty. Encouraging results have been reported following Femoroacetabular osteoplasty and arthroscopic treatment of Femoroacetabular Impingement.
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histopathologic features of the acetabular labrum in Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2004Co-Authors: Michael Leunig, Reinhold GanzAbstract:This paper summarizes clinical and histopathologic findings derived from 25 patients who had surgery for symptomatic Femoroacetabular Impingement. We explored if observed pathologic features were consistent with hypothesized mechanisms of injury, if severity of osteoarthritis and labral degeneration were associated, and if labral refixation would present an alternative. Clinically, all patients presented with limited range of motion at the hip attributable to pain and a positive Impingement test. Magnetic resonance arthrography and surgical observations showed degenerated or ruptured labra or both in the anterior and/or superior regions of the acetabular rim (24 of 25 specimens) which correlated with pain provocation, limited range of motion, and anatomic deformities. Histologically, labra were mostly hyperplastic with disorganized cystic matrices. No inflammation was observed. Spatial distribution of degenerated labral matrices was not different for the two Femoroacetabular Impingement mechanisms. Labral degeneration and severity of osteoarthritis observed on radiographs did not correlate. In patients having only joint debridement, the labral matrix at the tip, near its vascular supply, was normal. Femoroacetabular Impingement is a gentle chronic irritation of the labra located at the site of rupture that elicits a degenerative reaction. In early stages of the disease, the labral tip is not involved, providing the possibility of labral refixation after resection of the degenerated portion.
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anterior Femoroacetabular Impingement part i techniques of joint preserving surgery
Clinical Orthopaedics and Related Research, 2004Co-Authors: Martin Lavigne, Martin Beck, Reinhold Ganz, Klaus Arno Siebenrock, Javad Parvizi, Michael LeunigAbstract:The exact pathomechanism responsible for osteoarthritis (OA) of the nondysplastic hip has remained unknown for many years. There is, however, emerging clinical evidence implicating Femoroacetabular Impingement as an etiologic factor for having early OA of the hip develop. Femoroacetabular Impingement is an abutment conflict occurring between the proximal femur and the acetabular rim arising from morphologic abnormalities affecting the acetabulum or the proximal femur, or both. The repetitive mechanical conflict occurring during motion, particularly flexion and internal rotation, can lead to lesions of acetabular labrum and, even more serious, the adjacent acetabular cartilage. Surgical treatment of Femoroacetabular Impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. We will describe the rationale for the treatment of this condition, and discuss the technique of joint-preserving surgery.
Michael Leunig - One of the best experts on this subject based on the ideXlab platform.
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arthroscopic management of Femoroacetabular Impingement osteoplasty technique and literature review
American Journal of Sports Medicine, 2007Co-Authors: Marc J Philippon, Brian R Maxwell, Allston J. Stubbs, Reinhold Ganz, Mara L Schenker, Michael LeunigAbstract:Morphological and spatial abnormalities of the proximal femur and acetabulum have been recently recognized as causes of Femoroacetabular Impingement. During joint motion in hips with Femoroacetabular Impingement, abnormal bony contact occurs, and soft tissue structures (chondral and labral) often fail. Femoroacetabular Impingement has been reported to be a contributor to early-onset joint degeneration. Ganz et al have described good midterm success with an open surgical dislocation approach to reconstruct normal joint clearance. The purpose of this report is to discuss relevant literature and describe an arthroscopic approach to treat Femoroacetabular Impingement. This approach has particular relevance in high-demand patients, particularly in athletes seeking to return to high-level sport.
-
Femoroacetabular Impingement.
The Journal of the American Academy of Orthopaedic Surgeons, 2007Co-Authors: Javad Parvizi, Michael Leunig, Reinhold GanzAbstract:Evidence is emerging that subtle morphologic abnormalities around the hip, resulting in Femoroacetabular Impingement, may be a contributing factor in some instances to osteoarthritis in the young patient. The morphologic abnormalities result in abnormal contact between the femoral neck/head and the acetabular margin, causing tearing of the labrum and avulsion of the underlying cartilage region, continued deterioration, and eventual onset of arthritis. Nonsurgical treatment typically fails to control symptoms. Surgical management involves dislocation of the hip (while preserving the blood supply to the femoral head) and Femoroacetabular osteoplasty. Encouraging results have been reported following Femoroacetabular osteoplasty and arthroscopic treatment of Femoroacetabular Impingement.
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histopathologic features of the acetabular labrum in Femoroacetabular Impingement
Clinical Orthopaedics and Related Research, 2004Co-Authors: Michael Leunig, Reinhold GanzAbstract:This paper summarizes clinical and histopathologic findings derived from 25 patients who had surgery for symptomatic Femoroacetabular Impingement. We explored if observed pathologic features were consistent with hypothesized mechanisms of injury, if severity of osteoarthritis and labral degeneration were associated, and if labral refixation would present an alternative. Clinically, all patients presented with limited range of motion at the hip attributable to pain and a positive Impingement test. Magnetic resonance arthrography and surgical observations showed degenerated or ruptured labra or both in the anterior and/or superior regions of the acetabular rim (24 of 25 specimens) which correlated with pain provocation, limited range of motion, and anatomic deformities. Histologically, labra were mostly hyperplastic with disorganized cystic matrices. No inflammation was observed. Spatial distribution of degenerated labral matrices was not different for the two Femoroacetabular Impingement mechanisms. Labral degeneration and severity of osteoarthritis observed on radiographs did not correlate. In patients having only joint debridement, the labral matrix at the tip, near its vascular supply, was normal. Femoroacetabular Impingement is a gentle chronic irritation of the labra located at the site of rupture that elicits a degenerative reaction. In early stages of the disease, the labral tip is not involved, providing the possibility of labral refixation after resection of the degenerated portion.
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anterior Femoroacetabular Impingement part i techniques of joint preserving surgery
Clinical Orthopaedics and Related Research, 2004Co-Authors: Martin Lavigne, Martin Beck, Reinhold Ganz, Klaus Arno Siebenrock, Javad Parvizi, Michael LeunigAbstract:The exact pathomechanism responsible for osteoarthritis (OA) of the nondysplastic hip has remained unknown for many years. There is, however, emerging clinical evidence implicating Femoroacetabular Impingement as an etiologic factor for having early OA of the hip develop. Femoroacetabular Impingement is an abutment conflict occurring between the proximal femur and the acetabular rim arising from morphologic abnormalities affecting the acetabulum or the proximal femur, or both. The repetitive mechanical conflict occurring during motion, particularly flexion and internal rotation, can lead to lesions of acetabular labrum and, even more serious, the adjacent acetabular cartilage. Surgical treatment of Femoroacetabular Impingement focuses on improving the clearance for hip motion and alleviation of femoral abutment against the acetabular rim. We will describe the rationale for the treatment of this condition, and discuss the technique of joint-preserving surgery.
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Femoroacetabular Impingement as a Factor in the Development of Nonunion of the Femoral Neck: A Report of Three Cases
Journal of orthopaedic trauma, 2004Co-Authors: Martin Beck, Michael Leunig, Eric Clarke, Reinhold GanzAbstract:Objectives: Description of an anatomic condition where a Femoroacetabular Impingement was identified as the cause for the development of nonunion of the femoral neck. Design: Retrospective analysis. Setting: University hospital. Patients: Three patients, aged 27 to 74 years, in whom, after exclusion of other known factors, a Femoroacetabular Impingement was identified as the cause for the nonunion of a femoral neck fracture. Intervention: Surgical correction of the Femoroacetabular Impingement. Main Outcome Measurement: Intraoperative verification of Femoroacetabular Impingement. Healing of the femoral neck non-union. Results: In all 3 patients, Femoroacetabular Impingement was confirmed at surgery. After elimination of the cause for Impingement, all nonunions went on to uneventful healing. Conclusions: A Femoroacetabular Impingement mechanism is proposed as a cause for nonunion of femoral neck fractures. Predisposing factors such as bulging at the fracture site or decreased femoral-neck offset should be addressed at the time of initial fracture treatment.
