Mechanical Engineering, Stanford University, Stanford, CA 94305-4038, USA.
Am J Sports Med. 2011 Jul;39 Suppl:36S-42S. doi: 10.1177/0363546511413993.
Femoroacetabular impingement (FAI) has been linked to osteoarthritis. Treatment options range from nonoperative to operative, and current outcome measures are generally subjective or not conducted under actual activities of daily living. Thus, there is a need for the use of motion capture techniques to quantitatively assess the outcome of surgical intervention for those treated for FAI.
The gait of FAI patients 1 year after operative treatment (arthroscopic hip reshaping) will be significantly closer to the normal range and pattern of hip flexion motion, relative to pretreatment.
Case series; Level of evidence, 4.
Eleven patients between 18 and 44 years of age with diagnosed FAI were enrolled in this study. Kinematics and kinetics for this group of patients were collected using motion capture techniques before arthroscopic bone-reshaping surgery and again 1 year after surgery. Pain and perceived activity level (Tegner scale) were also collected. All collected data were compared using a paired t test.
Overall hip sagittal plane range of motion increased on the affected side from 27.6° ± 5.0° to 30.7° ± 4.3° (P = .02). The presence of abnormal reversals (second-order change in the slope in the hip flexion/extension curve) that was present in 5 patients preoperatively disappeared or was reduced in prevalence and magnitude in 4 of the patients postoperatively. Additionally, pain decreased and activity level increased postoperatively.
The results supported the hypothesis that surgical intervention for FAI restores more normal patterns of gait and provides objective support that the surgical procedure is useful. The results help establish motion capture as a potential method for quantitatively assessing the outcome in FAI surgical interventions. The presence of abnormal reversals in hip flexion has been reported in end-stage hip osteoarthritis, and the presence of these reversals in FAI patients reinforces the idea of FAI being a precursor to hip osteoarthritis.
股骨髋臼撞击症（FAI）与骨关节炎有关。治疗方案从非手术到手术不等，目前的结果测量通常是主观的，或者不是在日常生活活动下进行的。因此，需要使用运动捕捉技术来定量评估接受 FAI 治疗的患者的手术干预结果。
FAI 患者在接受手术治疗（关节镜下髋关节重塑）1 年后的步态将与术前相比更接近髋关节屈曲运动的正常范围和模式。
病例系列；证据水平，4 级。
本研究纳入了 11 名年龄在 18 至 44 岁之间的诊断为 FAI 的患者。使用运动捕捉技术收集该组患者的运动学和动力学数据，分别在关节镜下骨重塑手术前和手术后 1 年收集。还收集了疼痛和感知活动水平（Tegner 量表）。使用配对 t 检验比较所有收集的数据。
受影响侧的髋关节矢状面运动范围总体上从 27.6°±5.0°增加到 30.7°±4.3°（P=0.02）。术前 5 例患者存在异常反转（髋关节屈伸曲线斜率的二阶变化），术后 4 例患者的异常反转消失或减少。此外，术后疼痛减轻，活动水平提高。
研究结果支持了这样一个假设，即 FAI 的手术干预恢复了更正常的步态模式，并提供了客观的支持，表明手术程序是有用的。研究结果有助于确立运动捕捉作为定量评估 FAI 手术干预结果的潜在方法。髋关节屈曲异常反转已在髋关节骨关节炎的终末期报告，FAI 患者中存在这些反转，这强化了 FAI 是髋关节骨关节炎的前兆的观点。
