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Hip morphology predicts posterior hip impingement in a cadaveric model
William Z Morris1, Cody A Fowers1, Douglas S Weinberg1
11 Division of Pediatric Orthopaedics, Rainbow Babies and Children's Hospitals at Case Western Reserve University, Cleveland, OH, USA.
Summary
Increased femoral/acetabular version and coxa valga are linked to earlier posterior hip impingement. Careful correction during osteotomies is crucial to avoid overcorrection and potential impingement.
Area of Science:
- Orthopedic surgery
- Hip biomechanics
- Anatomy
Background:
- Posterior hip impingement is an emerging cause of hip pain.
- Understanding its predisposing morphologic traits is essential for diagnosis and treatment.
Purpose of the Study:
- To characterize posterior femoroacetabular and ischiofemoral impingement.
- To identify morphologic factors predisposing to posterior hip impingement.
Main Methods:
- 206 cadaveric hips underwent controlled motion to assess impingement during external rotation and adduction.
- Morphologic traits including femoral/acetabular version and true neck-shaft angle (TNSA) were measured.
Main Results:
- External rotation impingement commonly involved the femoral neck/acetabulum (83.0%).
- Adduction impingement primarily occurred between the lesser trochanter/ischial tuberosity (78.6%).
- Increased femoral/acetabular version and TNSA were associated with earlier impingement in specific motions.
Conclusions:
- Relative femoral/acetabular anteversion is linked to earlier posterior hip impingement.
- Coxa valga is associated with earlier adduction impingement but protective against external rotation impingement.
- Overcorrection of retroversion during osteotomies may increase the risk of posterior impingement.
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