Philippi Matthew T, Kahn Timothy L, Adeyemi Temitope F, Maak Travis G, Aoki Stephen K
Department of Orthopaedics, University of Utah, 590 Wakara Way, Salt Lake City, UT 84108, USA.
J Hip Preserv Surg. 2020 Feb 13;7(1):22-26. doi: 10.1093/jhps/hnaa007. eCollection 2020 Jan.
One etiological factor of femoroacetabular impingement syndrome (FAIS) is high impact athletics involving deep hip flexion, axial loading and jumping during skeletal development. Previous work has established that there is physiologic asymmetry of the lower limbs regarding function, with the dominant limb being primarily responsible for propulsion and kicking while the non-dominant limb is responsible for stability and planting. The authors hypothesize that the dominant limb will be more likely to undergo hip arthroscopy for symptomatic FAIS. Four hundred and sixty-nine patients at a single surgical center who underwent primary or revision hip arthroscopy for cam-type FAIS were identified. Patients were asked to identify their dominant lower extremity, defined as the lower extremity preferred for kicking. Sixty patients who indicated bilateral leg dominance were excluded. It was assumed that with no association between limb dominance and the need for surgery, the dominant side would have surgery 50% of the time. Enrichment for surgery in the dominant limb was tested for using a one-sample test of proportions, determining whether the rate differed from 50%. The enrichment for surgery on the dominant side was 57% (95% confidence interval 52-62%) which was significantly different from the rate expected by chance (50%), = 0.003. No other significant differences were noted between groups. Limb dominance appears to be an etiological factor in the development of cam-type FAIS. Patients are more likely to undergo arthroscopic treatment of FAIS on their dominant lower extremity, although the non-dominant lower extremity frequently develops FAIS as well.
股骨髋臼撞击综合征（FAIS）的一个病因是在骨骼发育期间涉及深度髋关节屈曲、轴向负荷和跳跃的高强度竞技运动。先前的研究已经证实，下肢在功能方面存在生理不对称性，优势侧下肢主要负责推进和踢腿，而非优势侧下肢则负责稳定和落地支撑。作者推测，优势侧下肢更有可能因有症状的FAIS而接受髋关节镜检查。在一个单一手术中心，确定了469例因凸轮型FAIS接受初次或翻修髋关节镜检查的患者。要求患者确定其优势下肢，定义为踢腿时更偏好使用的下肢。60例表示双侧下肢均为优势侧的患者被排除。假设肢体优势与手术需求之间无关联，优势侧接受手术的概率应为50%。使用单样本比例检验来测试优势侧肢体接受手术的富集情况，确定该比例是否与50%不同。优势侧接受手术的富集率为57%（95%置信区间52 - 62%），这与偶然预期的比例（50%）显著不同，P = 0.003。两组之间未发现其他显著差异。肢体优势似乎是凸轮型FAIS发病的一个病因。患者更有可能在其优势下肢接受FAIS的关节镜治疗，尽管非优势下肢也经常会发生FAIS。
