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LCPD: Reduced Range of Motion Resulting From Extra- and Intraarticular Impingement

Tannast, Moritz ; Hanke, Markus ; Ecker, Timo ; Murphy, Stephen ; Albers, Christoph ; Puls, Marc

In: Clinical Orthopaedics and Related Research®, 2012, vol. 470, no. 9, p. 2431-2440

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    Titre
    • LCPD: Reduced Range of Motion Resulting From Extra- and Intraarticular Impingement
    Auteur
    • Tannast, Moritz. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgsstrasse, 3010, Bern, Switzerland
    • Hanke, Markus. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgsstrasse, 3010, Bern, Switzerland
    • Ecker, Timo. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgsstrasse, 3010, Bern, Switzerland
    • Murphy, Stephen. Center for Computer Assisted and Reconstructive Surgery, New England Baptist Hospital, Tufts University School of Medicine, Boston, MA, USA
    • Albers, Christoph. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgsstrasse, 3010, Bern, Switzerland
    • Puls, Marc. Department of Orthopaedic Surgery, Inselspital, University of Bern, Freiburgsstrasse, 3010, Bern, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • Clinical Orthopaedics and Related Research®, 2012, vol. 470, no. 9, p. 2431-2440. Springer-Verlag
    Autre version électronique
    Classification
    • Santé
    Identifiant OAI-PMH
    • oai:doc.rero.ch:314069
    Summary
    Background: Legg-Calvé-Perthes disease (LCPD) often results in a deformity that can be considered as a complex form of femoroacetabular impingement (FAI). Improved preoperative characterization of the FAI problem based on a noninvasive three-dimensional computer analysis may help to plan the appropriate operative treatment. Questions/purposes: We asked whether the location of impingement zones, the presence of additional extraarticular impingement, and the resulting ROM differ between hips with LCPD and normal hips or hips with FAI. Methods: We used a CT-based virtual dynamic motion analysis based on a motion algorithm to simulate the individual motion for 13 hips with LCPD, 22 hips with FAI, and 27 normal hips. We then determined the motion and impingement pattern of each hip for the anterior (flexion, adduction, internal rotation) and the posterior impingement tests (extension, adduction, external rotation). Results: The location of impingement zones in hips with LCPD differed compared with the FAI/normal groups. Intra- and extraarticular impingement was more frequent in LCPD (79% and 86%, respectively) compared with normal (15%, 15%) and FAI hips (36%, 14%). Hips with LCPD had decreased amplitude for all hip motions (flexion, extension, abduction, adduction, internal and external rotation) compared with FAI or normal. Conclusions: Hips with LCPD show a decreased ROM as a result of a higher prevalence of intra- and extraarticular FAI. Noninvasive assessment of impingement characteristics in hips with LCPD may be helpful in the future for establishment of a surgical plan