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Three-dimensional assessment of cam engagement in femoroacetabular impingement

Emmanuel Audenaert (UGent) , PETER MAHIEU (UGent) and Christophe Pattyn (UGent)
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Abstract
Purpose: The purpose of our study was to 3-dimensionally assess cam engagement in male patients with symptomatic femoroacetabular impingement during motion. Methods: A total of 13 hips with cam-type impingement were investigated. Patient anatomy and clinical range of motion were determined. After 3-dimensional segmentation and reconstruction, the dynamic behavior of the cam lesion was investigated for the previously analyzed motions. Results: Important differences in the pattern of cam engagement were noticed. Abutment of the cam lesion and the acetabular cartilage was observed in flexion in 7 hips (54%) and in abduction in 11 hips (84%). Internal rotation with the hip in 90 degrees of flexion caused intrusion of the cam lesion into the joint in 10 of the investigated cases (77%). Neutral rotation did not cause any conflict between the cam lesion and acetabulum for the measured range of motion. A similar area in the anterosuperior quadrant of the acetabulum appeared to be involved in the different motions that were analyzed. Conclusions: Typically, during internal rotation in 90 degrees of flexion, the centromedial portion of the cam lesion was found to abut against the anterosuperior quadrant of the acetabular cartilage. During abduction and flexion, this appeared to be the lateral and medial portions of the cam lesion, respectively. All motions causing cam intrusion appeared to focus on the same cartilage area of the acetabulum in its anterosuperior quadrant. Level of Evidence: Level II, diagnostic study.
Keywords
NORMAL RANGE, HIP, KNEE, MOTION, TRACKING, KINEMATICS, JOINTS, OSTEOARTHRITIS

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Chicago
Audenaert, Emmanuel, PETER MAHIEU, and Christophe Pattyn. 2011. “Three-dimensional Assessment of Cam Engagement in Femoroacetabular Impingement.” Arthroscopy-the Journal of Arthroscopic and Related Surgery 27 (2): 167–171.
APA
Audenaert, E., MAHIEU, P., & Pattyn, C. (2011). Three-dimensional assessment of cam engagement in femoroacetabular impingement. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, 27(2), 167–171.
Vancouver
1.
Audenaert E, MAHIEU P, Pattyn C. Three-dimensional assessment of cam engagement in femoroacetabular impingement. ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY. 2011;27(2):167–71.
MLA
Audenaert, Emmanuel, PETER MAHIEU, and Christophe Pattyn. “Three-dimensional Assessment of Cam Engagement in Femoroacetabular Impingement.” ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 27.2 (2011): 167–171. Print.
@article{1191649,
  abstract     = {Purpose: The purpose of our study was to 3-dimensionally assess cam engagement in male patients with symptomatic femoroacetabular impingement during motion. Methods: A total of 13 hips with cam-type impingement were investigated. Patient anatomy and clinical range of motion were determined. After 3-dimensional segmentation and reconstruction, the dynamic behavior of the cam lesion was investigated for the previously analyzed motions. Results: Important differences in the pattern of cam engagement were noticed. Abutment of the cam lesion and the acetabular cartilage was observed in flexion in 7 hips (54\%) and in abduction in 11 hips (84\%). Internal rotation with the hip in 90 degrees of flexion caused intrusion of the cam lesion into the joint in 10 of the investigated cases (77\%). Neutral rotation did not cause any conflict between the cam lesion and acetabulum for the measured range of motion. A similar area in the anterosuperior quadrant of the acetabulum appeared to be involved in the different motions that were analyzed. Conclusions: Typically, during internal rotation in 90 degrees of flexion, the centromedial portion of the cam lesion was found to abut against the anterosuperior quadrant of the acetabular cartilage. During abduction and flexion, this appeared to be the lateral and medial portions of the cam lesion, respectively. All motions causing cam intrusion appeared to focus on the same cartilage area of the acetabulum in its anterosuperior quadrant. Level of Evidence: Level II, diagnostic study.},
  author       = {Audenaert, Emmanuel and MAHIEU, PETER and Pattyn, Christophe},
  issn         = {0749-8063},
  journal      = {ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY},
  keyword      = {NORMAL RANGE,HIP,KNEE,MOTION,TRACKING,KINEMATICS,JOINTS,OSTEOARTHRITIS},
  language     = {eng},
  number       = {2},
  pages        = {167--171},
  title        = {Three-dimensional assessment of cam engagement in femoroacetabular impingement},
  url          = {http://dx.doi.org/10.1016/j.arthro.2010.06.031},
  volume       = {27},
  year         = {2011},
}

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