Femoroacetabular Impingement

Does Corrective Surgery in Femoroacetabular Impingement Improve Joint Kinematics During Squatting?

INTRODUCTION: Cam femoroacetabular impingement (FAI) is characterized by an osseous overgrowth on the femoral head-neck junction [1], leading to pain and limited range of motion (ROM) during daily life activities [2]. Corrective surgery is highly recommended and performed in order to reduce or eliminate pain and further development of osteoarthritis (OA). However, it is still unclear whether it would lead to improved functional mobility. The purpose was to compare kinematic variables of the operated limb between FAI patients when performing a squat task pre-surgery and at around 2-year follow-up. A secondary objective consisted of express the results in a biomechanical functional score to quantify the joint kinematics of FAI patients compared to healthy control (CTRL) participants. METHODS: Eleven male patients (7 arthroplasty: 34.6±8.1 years, 25.7±3.2 kg/m2; 4 open: 33.3±7.1 years, 24.9±1.9 kg/m2) and 21 CTRL (2F/19M, 33.4±6.7 years, 25.4±3.3 kg/m2) participants were recruited from the orthopaedic surgeon’s clinical practice. Patients were assigned to either an arthroplasty or open FAI surgery correction. The participants signed prior to their participation a consent form approved by the hospital and university ethics board. Patients agreed to undergo motion analysis prior to and 2 years after the surgery. The CTRL were selected based on similar age and BMI as the FAI group and underwent the same motion analysis protocol. At the local hospital, CT scan was performed in all participants to confirm an alpha-angle higher than 55º and also establish their pelvic and knee bony landmarks. At the motion laboratory, the participants were outfitted with 45 reflective markers and performed a minimum of five trials of deep squat at a self-selected pace. Three-dimensional joint kinematics (200 Hz) of the lower limbs were captured using a ten-camera motion analysis system (Vicon, UK). Kinematics data were processed in Nexus 1.8.3 (Vicon, UK) using a modified Plug-In-Gait model and exported with a custom MATLAB script (Mathworks, USA) to calculate group averages and extract relevant variables. All trials were time-normalized based on a full squat cycle (descent and ascent phases) and individual averages for each participant were calculated across the trials. Four kinematic variables were included in the analysis: pelvis, hip, knee, and ankle sagittal angles. The normalized root-mean-square deviation (nRMSD) was calculated between the FAI and the CTRL groups for both pre- and post-surgery conditions, expressed by
Listed In: Biomechanical Engineering, Biomechanics, Orthopedic Research