PURPOSE: This study evaluated the usefulness of ultrasonography for a diagnosis of acetabular labral tear in femoroacetabular impingement (FAI). MATERIALS AND METHODS: From March 2010 to October 2011, an ultrasonographic examination was performed in 58 patients(58 hips: 26 men and 32 women) with acetabular labral tear. The sensitivity and positive predictive value of ultrasonography were evaluated for 58 cases with acetabular labral tear confirmed by hip arthroscopy. RESULTS: The sensitivity and positive predictive value for an acetabular labral tear using ultrasonography was 89.6% and 100%, respectively. The concordance rate of an acetabular labral tear between arthroscopy and ultrasonography was 84.6%. CONCLUSION: Hip ultrasonography can make a significant contribution to a pathologic diagnosis and isa useful diagnostic tool for acetabular labral tears.
Arthroscopy ; Femoracetabular Impingement ; Hip ; Humans ; Male

PURPOSE: We wanted to report the clinical results of arthroscopic resection of osseous abnormality that caused femoroacetabular impingement MATERIALS AND METHODS: Among 38 cases of patients who had their causes diagnosed as femoroacetabular impingement and who were treated by arthroscopy from April 2000 to August 2005, 21 cases of the patients who were operated on for resection of the acetabular labrum before August 2004 are categorized as group 1; after that, 17 cases of patients who were operated on for bumpectomy or acetabuloplasty were categorized as group 2. RESULTS: The pain scores for all the patients during the preoperative phase, the 2nd week, the 6th week, the 3rd month, the 6th month and the 1st year were 0.57, 1.57, 2.10, 2.19, 2.38 and 2.33, respectively, for group 1 and 0.65, 0.59, 1.41, 1.65, 2.12 and 2.47, respectively, for group 2, which showed improvement from the medical view. The differences between the pain scores of the preoperative phase and the 2nd week postoperatively were an average of 1.00 and -0.06, respectively, in group 1 and group 2, which showed aggravation of the clinical condition of group 1 compared to that of group 2. The differences between the pain scores of the preoperative phase and the 1st year of the postoperative phase were an average of 1.76 and 1.82 in group 1 and group 2, respectively, which presents the better improvement in the medical condition of group 2. 15 out of 21 people in group 1 (71%) and 14 out of 17 people in group in group 2 (82%) were satisfied after the operation. CONCLUSION: Removal of osseous deformity through arthroscopy, compared with the aspects of the clinical conditions as based on the result of partial labrectomy, causes pain in the early days of the postoperative phase. However, the results of the 1 year progression of postoperative phase present a favorable turn of the patients' clinical condition.
Acetabulum ; Arthroscopy ; Congenital Abnormalities ; Femoracetabular Impingement* ; Humans

PURPOSE: To report the mid- and long-term follow up results of patients who underwent arthroscopic treatment after being diagnosed with femoroacetabular impingement. MATERIALS AND METHODS: 72 consecutive patients diagnosed with femoroacetabular impingement underwent arthroscopic partial labrectomy and femoroplasty(79 cases). In order to evaluate the clinical results, a modified Harris hip score, and VAS and Hip outcome scores were utilized. In addition, the alpha angle and femoral offset were measured radiologically. RESULTS: Based on the clinical results from all consecutive patients, the preoperative mean pain score was 6.0 and 1.7, and 2.1 points on the mid-(2-5 years) and long-term(5-7 years) follow ups, respectively. The mean modified Harris hip score improved from 58.9 points to 81.9 and 79.3 points for the mid-term and long-term follow up groups, respectively. Prior to surgery, the daily activity scale and motor scale results associated with Hip outcome scores were 59.2 and 57.5 points for the mid- and long-term groups, respectively. These scores improved to 84.7 and 84.5, and 81.2 and 79.5 for each group upon the mid- and long-term postoperative follow ups, respectively. Based on the radiological results, the mean alpha angle decreased from 61.2degrees preoperatively to 40.9degrees after surgery, and the mean femoral offset increased from 4.8 mm to 10.0 mm. CONCLUSION: The mid- and long-term clinical and radiological follow ups to evaluate the results of arthroscopic treatment of femoroacetabular impingement revealed satisfactory improvement. This finding further demonstrates that arthroscopy is an effective and safe treatment for cases of femoroacetabular impingement.
Arthroscopy ; Femoracetabular Impingement ; Follow-Up Studies ; Hip ; Humans

Femoroacetabular impingement and dysplatic hip joint is well known cause of osteoarthritis. In these diseases, labral tear and subsequent cartilage damage is thought to be main pathophysiology of development of osteoarthritis. If there are no known bony abnormalities, we called it as idiopathic osteoarthritis. Normal appearance of acetabular labrum is a continuous, usually triangular structure that attaches to the bony rim of the acetabulum and is completed at the inferior portion by the transverse acetabular ligament over the acetabular notch. A few authors reported intra-articular labrum and its relation to the development of osteoarthritis. But they didn't comment the primary bony abnormality especially acetabulum. We'd like to report x-ray, computed tomogram, magnetic resonance arthrogram and arthroscopic findings of a case had double contour sign of acetabular dome combined with intrusion of acetabular labrum.
Acetabulum* ; Cartilage ; Femoracetabular Impingement ; Hip Joint ; Hip* ; Ligaments ; Osteoarthritis

PURPOSE: A patient diagnosed with early osteoarthritis due to hip pain who went through arthroscopic treatment were studied in the radiologic aspect and clinical aspect of anterior femoroacetabular impingement (FAI). MATERIALS AND METHODS: The subjects were 43 early osteoarthritis patients from May 1995 to May 2003 who underwent arthroscopic treatment and were able to be followed for at least 1 year. These patients were divided into two groups, the first group with patients who had no osteoarthritis on simple radiograph but with degenerative changes of the labrum and cartilage on MR arthorgram and arthroscopy, and the second group with osteoarthirtic findings on simple radiograph. Both groups were checked to see if they showed signs of anterior FAI at the acetabulum and proximal femur on radiograph and MR arthrogram. Improvement after surgery was evaluated using the JOA (Japanese Orthopaedic Association) pain score. RESULTS: About FAI, 6 patients (29%) out of 21 in group 1 showed radiologic evidence of FAI, while 12 of out 22 (56%) had it in group 2, with a total of 18 patients (42%). The pain score of pre/post operation were improved in group 1 which showed evidence of FAI and while the score of group 2 were improved from 0.83 to 1.83 and 0.92 to 1.67 in group 2. And the pain score of the group 1 which showed no evidence of FAI were improved from 0.73 to 2.60 and the score of group 2 were improved from 0.60 to 2.10. As a result, there was small improvement in pain scores of patient group with FAI. CONCLUSION: Among the patients who were diagnosed with early primary osteoarthritis of th hip, we could find anterior femoroacetabular impingement in the radiogram in some cases and the patients with FAI have low pain relief. Therefore we can expect more improved clinical result with inspection of the anterior FAI.
Acetabulum ; Arthroscopy ; Cartilage ; Femoracetabular Impingement* ; Femur ; Hip* ; Humans ; Osteoarthritis*

PURPOSE: To analyze, using finite element model analysis, the causes of postoperative pain in patients who had arthroscopic treatment for femoroacetabular impingement (FAI). MATERIALS AND METHODS: Ten patients with FAI treated by arthroscopic surgery between July 2004 and July 2007 were selected. Five cases whose condition improved to a pain score of 3 postoperatively were assigned to comparative group A and 5 cases who had a second operation done due to a pain score of 1 were assigned to experimental group B. Finite element model analysis was done for the impingement test position. Femoral offset and alpha angle were measured to compare with contact pressure or von Mises stress. RESULTS: Preoperative von Mises stress and contact pressure were all higher in group B than group A. Maximal stress and pressure location was the anterolateral surface of the femoral head and neck, and this location was removed more accurately in group A. CONCLUSION: Finite element model analysis of FAI indicated that incomplete removal of a bump was the cause of pain, and that accurate location of the lesion and adequate bump removal are the definitive factors in reducing pain.
Arthroscopy ; Femoracetabular Impingement ; Head ; Hip ; Humans ; Neck ; Pain, Postoperative

PURPOSE: The purpose of this study is to determine structural bony abnormalities predisposing for femoroacetabular impingement by comparison of patients with and without mechanical symptoms. MATERIALS AND METHODS: We conducted this comparative study on 151 patients (151 hips; mean age 44.8 years; range 16-73 years) with mechanical symptoms with results of multi-detector computed tomography (MDCT) arthrography (the symptomatic group). Each patient was matched with a control who underwent MDCT due to ureter stone (the asymptomatic group) in terms of age, gender, site (right or left), and time at diagnosis. Acetabular evaluations, which included cranial and central anteversion and anterior and lateral center edge angles and femoral measurements, were performed. In addition, we evaluated the prevalence and characteristics of structural bone abnormalities between the two groups. RESULTS: The prevalence for patients who had at least one structural bony abnormality in the symptomatic and asymptomatic groups was 80.1% (121/151) and 54.3% (82/151), respectively (odds ratio: 3.39, 95% confidence interval: 2.30-5.66; P<0.001). The most common osseous abnormality was the isolated Pincer type in both groups: 89 (73.6%) of 121 hips with an osseous abnormality in the symptomatic group and 57 (69.5%) of 82 hips with an osseous abnormality in the asymptomatic group. By analysis of CT arthrography in symptomatic patients, a labral tear was found in 107 hips (70.9%), and 86 (80%) of these hips had a structural bony abnormality. CONCLUSION: A significantly greater prevalence rate of structural bony abnormality was observed for the symptomatic group than for the asymptomatic group. These findings are helpful for development of appropriate treatment plans.
Acetabulum ; Arthrography ; Diagnosis ; Femoracetabular Impingement ; Hip ; Hip Joint* ; Humans ; Multidetector Computed Tomography ; Prevalence ; Ureter

Femoroacetabular Impingement (FAI) arises from morphological abnormalities between the proximal femur and acetabulum. Impingement caused by these morphologic abnormalities induces early degenerative changes in the hip joint. Furthermore, FAI patients complain of severe pain and limited range of motion in the hip, but a guideline for treatment of FAI has not yet been established. Medication, supportive physical treatment and surgical procedures have been used in the treatment of the FAI patients; however, the efficacies of these treatments have been limited. Here, we report the diagnosis and treatment for 3 cases of FAI patients. Intra-articular (IA) steroid injection of the hip joint was performed in all three patients. After IA injection, pain was reduced and function had improved for up to three months.
Acetabulum ; Femoracetabular Impingement ; Femur ; Hip ; Hip Joint ; Humans ; Injections, Intra-Articular ; Osteoarthritis, Hip ; Range of Motion, Articular

Hip arthroscopy has been useful for resolving unexplained pains of the hip joint, despite its clinical applicability came after many other joints. Surgical indications have been increasing recently. Moreover, additional surgical techniques allow both the anatomy and function to return to its normal state. Recently, the concepts and treatments for extra-articular pathologies, such as deep gluteal syndrome, ischiofemoral impingement, subspinal impingement and iliopsoas impingement as well as classic indication, such as femoroacetabular impingement, acetabular labral tear, loose bodies, and synovial osteochondromatosis have been introduced. We present a diagnosis and treatment for diverse indications of hip arthroscopy, preoperative considerations, surgical technique and postoperative rehabilitation.
Acetabulum ; Arthroscopy* ; Chondromatosis, Synovial ; Diagnosis ; Femoracetabular Impingement ; Hip Joint ; Hip* ; Joints ; Pathology ; Rehabilitation ; Tears

Femoroacetabular impingement (FAI) results from abnormal anatomic relationship between acetabulum and femoral head-neck junction, which causes secondary chondrolabral injury. FAI is the common cause of hip joint pain in young adults who have nearly normal hip joint structure. The pain usually progresses on hip flexion and internal rotation. Although it is still controversial whether FAI is one of the reason of secondary hip osteoarthritis or the contrary, instruments and surgical technique for treating FAI is continuing to improve. When we initially diagnosed with FAI, conservative treatment is recommended. But if the conservative treatment has no response, we can consider surgical intervention. The arthroscopic technique is one of the promising options, and it is the fastest growing fields for the treatment FAI.
Acetabulum ; Arthroscopy ; Femoracetabular Impingement* ; Hip ; Hip Joint ; Humans ; Osteoarthritis, Hip ; Young Adult