Citation

Nogier A, Bonin N, May O, Gedouin JE, Bellaiche L, Boyer T, Lequesne M. Orthop. Traumatol. Surg. Res. 2010; 96(8 Suppl): S53-8.

Affiliation

Nollet Institute, 23, rue Brochant, 75017 Paris, France.

Copyright

(Copyright © 2010, Elsevier Publishing)

DOI

10.1016/j.otsr.2010.09.005

PMID

21035417

Abstract

Two hundred and ninety-two patients, aged between 16 and 50years and presenting with mechanical hip pathology, were included in a prospective multicenter study. The descriptive study concerned the clinical examination and analysis of three X-ray views (AP pelvic, Lequesne false profile and lateral axial view). The series comprised 62% males, mean age 35years, with 53% right side and 22% bilateral involvement. Initial trauma was reported in 19% of cases, and direct familial history of hip pathology in 20%. Seventy percent of the patients played sports, 30% were high-level athletes, and 17% played combat sports. The physical impingement sign was present in 18% to 65% of cases depending on the variant studied. On imaging (n=241), 62% of hips showed osteoarthritis, with 25% at the evolved stage. In the series, as a whole, there was a 35% rate of dysplasia, 63% of impingement and 5% of normal X-ray results. The radiologic impingement aspects were 58% cam-type, 19% pincer-type and 23% mixed. Twenty-two percent of dysplasia cases showed signs of associated impingement. Pain experienced exclusively in flexion/internal rotation/adduction on examination showed little sensitivity (20%) but considerable specificity (86%) for the main diagnosis of impingement. The links between impingement and dysplasia are discussed, and an integrative schema of all risk factors is put forward. LEVEL OF EVIDENCE: IV, descriptive epidemiological study.

Language: en