Scottish Rite for Children, Dallas, TX, USA.
Scottish Rite for Children, Dallas, TX, USA; University of Texas Southwestern Medical Center, Dallas, TX, USA.
Gait Posture. 2024 Mar;109:213-219. doi: 10.1016/j.gaitpost.2024.02.006. Epub 2024 Feb 6.
Femoroacetabular impingement (FAI) is a condition where the femoral head-neck junction collides with the acetabulum. Open or arthroscopic treatment of FAI aims to increase hip motion while reducing impingement during passive or dynamic movements.
What are the biomechanical characteristics of the hip and pelvis in adolescents and young adults diagnosed with FAI syndrome 1) pre-operatively compared to controls and 2) pre- to post-operatively?
43 patients with FAI and 43 controls were included in the study. All patients with FAI had cam deformities and underwent unilateral hip preservation surgery (either open or arthroscopic). Pre- and post-operative imaging, patient-reported outcomes, and gait analysis were performed. Joint angles and internal joint moments were evaluated with an emphasis on the pelvis and hip. A comparative analysis was conducted to evaluate the gait patterns before and after surgical treatment, as well as to compare pre-operative gait patterns to a control group.
43 patients with FAI (28 female, 16.5 ± 1.5 yrs) and 43 controls (28 female, 16.0 ± 1.5 yrs) were included. Pre-operative patients with FAI had decreased stride length and walking speed compared to controls, with no significant change following surgery. There were no differences in sagittal and coronal plane hip and pelvis kinematics comparing pre- to post-operative and pre-operative to controls. Pre-operatively, differences in internal hip rotation angle (pre: 3.3˚, post: 3.9˚, controls: 7.7˚) and hip extensor moment (pre: 0.121, post: 0.090, controls: 0.334 Nm/kg) were observed compared to controls with no significant changes observed following surgery.
Compensatory movement strategies in pelvic and hip motion are evident during gait in patients with FAI, particularly in the sagittal and transverse planes. These strategies remained consistent two years post-surgery. While surgery improved radiographic measures and patient-reported outcomes, gait did not elicit biomechanical changes following surgical treatment.
髋关节撞击症（FAI）是一种股骨头颈交界处与髋臼碰撞的病症。FAI 的开放式或关节镜治疗旨在增加髋关节运动，同时减少被动或动态运动中的撞击。
1）与对照组相比，诊断为 FAI 综合征的青少年和年轻人在术前髋关节和骨盆的生物力学特征如何；2）与术前相比，术后髋关节和骨盆的生物力学特征如何？
本研究纳入了 43 例 FAI 患者和 43 例对照组。所有 FAI 患者均有凸轮畸形，并接受了单侧髋关节保髋手术（开放式或关节镜式）。对所有患者进行术前和术后影像学、患者报告的结果和步态分析。重点评估骨盆和髋关节的关节角度和关节内力矩。进行对比分析以评估手术治疗前后的步态模式，并将术前步态模式与对照组进行比较。
本研究纳入了 43 例 FAI 患者（28 例女性，平均年龄 16.5±1.5 岁）和 43 例对照组（28 例女性，平均年龄 16.0±1.5 岁）。与对照组相比，术前 FAI 患者的步幅和行走速度降低，术后无明显变化。与对照组相比，术前至术后和术前至对照组的骨盆和髋关节矢状面和冠状面运动学无差异。与对照组相比，术前髋关节内旋角度（术前：3.3°，术后：3.9°，对照组：7.7°）和髋关节伸肌力矩（术前：0.121，术后：0.090，对照组：0.334 Nm/kg）存在差异，术后无明显变化。
FAI 患者在步态中存在骨盆和髋关节运动的代偿性运动策略，特别是在矢状面和横断面上。这些策略在手术后两年内仍然保持一致。虽然手术改善了影像学测量和患者报告的结果，但步态在手术后并没有引起生物力学变化。
