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Is the hip capsule thicker in diseased hips?
K S Rakhra1, A A Bonura2, R Nairn3
1Associate Professor, The Ottawa Hospital/Ottawa Hospital Research Institute, General Campus, 501 Smyth Road, Ottawa, Ontario, K1H 8L6, Canada krakhra@toh.on.ca.
Insights
The hip capsule is thicker in patients with surgical hip disease compared to healthy individuals. However, the increased thickness is not specific to cam-femoroacetabular impingement (FAI) or other hip pathologies.
Area of Science:
- Orthopedics
- Radiology
- Hip Pathophysiology
Background:
- Hip capsule thickness is a potential indicator of hip joint pathology.
- Understanding variations in capsule thickness can aid in diagnosing and managing hip conditions.
Purpose of the Study:
- To compare hip capsule thickness in patients with cam-femoroacetabular impingement (FAI) and non-FAI hip disease against asymptomatic controls.
- To determine if capsule thickness differs between cam-FAI and non-FAI hip pathologies.
Main Methods:
- 3 Tesla MRI was used to measure maximal anterior and superior hip capsule thickness in 56 hips across three groups: cam-FAI, non-FAI hip disease, and asymptomatic controls.
- Statistical analysis, including student's t-test and Pearson's correlation coefficient, was employed to compare groups and assess the relationship between alpha angle and capsule thickness.
Main Results:
- The hip capsule was significantly thicker superiorly in both cam-FAI and non-FAI surgical groups compared to the asymptomatic group.
- Superior capsule thickness exceeded anterior thickness in both surgical groups but not in controls.
- No significant correlation was found between alpha angle and capsule thickness, nor were gender differences observed.
Conclusions:
- Hip capsule thickness is greater in diseased surgical hips than in asymptomatic hips.
- Increased hip capsule thickness is not specific to cam-FAI or non-FAI hip disease etiology.
- Capsule thickness measurements may serve as a general indicator of hip pathology rather than differentiating specific conditions.
Objectives:
The purpose of this study was to compare the thickness of the hip capsule in patients with surgical hip disease, either with cam-femoroacetabular impingement (FAI) or non-FAI hip pathology, with that of asymptomatic control hips.
Methods:
A total of 56 hips in 55 patients underwent a 3Tesla MRI of the hip. These included 40 patients with 41 hips with arthroscopically proven hip disease (16 with cam-FAI; nine men, seven women; mean age 39 years, 22 to 58) and 25 with non-FAI chondrolabral pathology (four men, 21 women; mean age 40 years, 18 to 63) as well as 15 asymptomatic volunteers, whose hips served as controls (ten men, five women; mean age 62 years, 33 to 77). The maximal capsule thickness was measured anteriorly and superiorly, and compared within and between the three groups with a gender subanalysis using student's t-test. The correlation between alpha angle and capsule thickness was determined using Pearson's correlation coefficient.
Results:
Superiorly, the hip capsule was significantly greater in cam- (p = 0.028) and non-FAI (p = 0.048) surgical groups compared with the asymptomatic group. Within groups, the superior capsule thickness was significantly greater than the anterior in cam- (p < 0.001) and non-FAI (p < 0.001) surgical groups, but not in the control group. There was no significant correlation between the alpha angle and capsule thickness. There were no gender differences identified in the thickness of the hip capsule.
Conclusion:
The thickness of the capsule does not differ between cam- and non-FAI diseased hips, and thus may not be specific for a particular aetiology of hip disease. The capsule is, however, thicker in diseased surgical hips compared with asymptomatic control hips.Cite this article: K. S. Rakhra, A. A. Bonura, R. Nairn, M. E. Schweitzer, N. M. Kolanko, P. E. Beaule. Is the hip capsule thicker in diseased hips? Bone Joint Res 2016;5:586-593. DOI: 10.1302/2046-3758.511.2000495.
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