Department of Mechanical Engineering, Stanford University, 219 Durand Bldg. MC: 4038, Stanford, California 94305, USA.
J Orthop Res. 2013 Sep;31(9):1461-8. doi: 10.1002/jor.22375. Epub 2013 Apr 26.
Femoroacetabular impingement (FAI) has been recognized as a significant clinical problem. While hip reshaping surgery for treating FAI has had positive clinical outcomes, there remains a need for objective functional outcomes of FAI treatment. We tested the hypothesis that during walking and stair climbing significant changes in hip kinematics would occur following hip reshaping surgery that indicate restoration of normal function post-operatively. Hip and pelvic kinematics were collected for 17 FAI patients pre- and 1 year post-operatively and compared to 17 healthy matched controls. Prior to surgery, FAI patients had significantly reduced hip internal rotation and hip sagittal plane range of motion during walking (p = 0.01, p < 0.001, respectively) and stair climbing (p = 0.01, p < 0.001, respectively) as compared with controls. Post-operatively, these motions were restored to normal during walking (p = 0.70, p = 0.46, respectively), but remained significantly reduced in the FAI patients during stair climbing (p = 0.03, p < 0.001, respectively). These results have important implications for understanding the functional pathomechanics of FAI and providing an objective basis for evaluating treatment outcome. The stair climbing results indicate that problems still exist in the hip joint for activities requiring higher ranges of hip motion and suggest a basis for exploring future improvements for the treatment of FAI.
髋关节撞击症(FAI)已被认为是一个重要的临床问题。虽然髋关节成形术治疗 FAI 具有积极的临床效果,但仍需要客观的 FAI 治疗的功能结果。我们假设在行走和爬楼梯时,髋关节成形术后髋关节运动学将发生显著变化,这表明术后功能恢复正常。我们收集了 17 例 FAI 患者术前和术后 1 年的髋关节和骨盆运动学数据,并与 17 名健康匹配的对照组进行了比较。在手术前,FAI 患者在行走(p=0.01,p<0.001)和爬楼梯(p=0.01,p<0.001)时髋关节内旋和髋关节矢状面活动范围明显减小,与对照组相比。术后,这些运动在行走时恢复正常(p=0.70,p=0.46),但在爬楼梯时仍明显减小(p=0.03,p<0.001)。这些结果对于理解 FAI 的功能发病机制具有重要意义,并为评估治疗结果提供了客观依据。爬楼梯的结果表明,对于需要更高髋关节运动范围的活动,髋关节仍然存在问题,并为探索未来改善 FAI 治疗提供了依据。