BACKGROUND: Femoroacetabular impingement is a recognized cause of chondrolabral injury. Although surgical treatment for impingement seeks to improve range of motion, there are very little normative data on dynamic impingement-free hip range of motion (ROM) in asymptomatic people. Hip ultrasound demonstrates labral anatomy and femoral morphology and, when used dynamically, can assist in measuring range of motion. QUESTIONS/PURPOSES: The purposes of this study were (1) to measure impingement-free hip ROM until labral deflection is observed; and (2) to measure the maximum degree of sagittal plane hip flexion when further flexion is limited by structural femoroacetabular abutment. METHODS: Forty asymptomatic adult male volunteers (80 hips) between the ages of 21 and 35 years underwent bilateral static and dynamic hip ultrasound examination. Femoral morphology was characterized and midsagittal flexion passive ROM was measured at two points: (1) at the initiation of labral deformation; and (2) at maximum flexion when the femur impinged on the acetabular rim. The mean age of the subjects was 28 ± 3 years and the mean body mass index was 25 ± 4 kg/m(2). RESULTS: Mean impingement-free hip passive flexion measured from full extension to initial labral deflection was 68° ± 17° (95% confidence interval [CI], 65-72). Mean maximum midsagittal passive flexion, measured at the time of bony impingement, was 96° ± 6° (95% CI, 95-98). CONCLUSIONS: Using dynamic ultrasound, we found that passive ROM in the asymptomatic hip was much less than the motion reported in previous studies. Measuring ROM using ultrasound is more accurate because it allows anatomic confirmation of terminal hip motion. CLINICAL SIGNIFICANCE: Surgical procedures used to treat femoroacetabular impingement are designed to restore or increase hip ROM and their results should be evaluated in light of precise normative data. This study suggests that normal passive impingement-free femoroacetabular flexion in the young adult male is approximately 95°.
BACKGROUND: Femoroacetabular impingement is a recognized cause of chondrolabral injury. Although surgical treatment for impingement seeks to improve range of motion, there are very little normative data on dynamic impingement-free hip range of motion (ROM) in asymptomatic people. Hip ultrasound demonstrates labral anatomy and femoral morphology and, when used dynamically, can assist in measuring range of motion. QUESTIONS/PURPOSES: The purposes of this study were (1) to measure impingement-free hip ROM until labral deflection is observed; and (2) to measure the maximum degree of sagittal plane hip flexion when further flexion is limited by structural femoroacetabular abutment. METHODS: Forty asymptomatic adult male volunteers (80 hips) between the ages of 21 and 35 years underwent bilateral static and dynamic hip ultrasound examination. Femoral morphology was characterized and midsagittal flexion passive ROM was measured at two points: (1) at the initiation of labral deformation; and (2) at maximum flexion when the femur impinged on the acetabular rim. The mean age of the subjects was 28 ± 3 years and the mean body mass index was 25 ± 4 kg/m(2). RESULTS: Mean impingement-free hip passive flexion measured from full extension to initial labral deflection was 68° ± 17° (95% confidence interval [CI], 65-72). Mean maximum midsagittal passive flexion, measured at the time of bony impingement, was 96° ± 6° (95% CI, 95-98). CONCLUSIONS: Using dynamic ultrasound, we found that passive ROM in the asymptomatic hip was much less than the motion reported in previous studies. Measuring ROM using ultrasound is more accurate because it allows anatomic confirmation of terminal hip motion. CLINICAL SIGNIFICANCE: Surgical procedures used to treat femoroacetabular impingement are designed to restore or increase hip ROM and their results should be evaluated in light of precise normative data. This study suggests that normal passive impingement-free femoroacetabular flexion in the young adult male is approximately 95°.
Authors: Andrew Vollman; Rachel Hulen; Scott Dulchavsky; Howard Pinchcofsky; David Amponsah; Gordon Jacobsen; Alexandria Dulchavsky; Marnix van Holsbeeck Journal: J Clin Ultrasound Date: 2014-01-22 Impact factor: 0.910
Authors: Martin Beck; Michael Leunig; Javad Parvizi; Vincent Boutier; Daniel Wyss; Reinhold Ganz Journal: Clin Orthop Relat Res Date: 2004-01 Impact factor: 4.176
Authors: Reinhold Ganz; Javad Parvizi; Martin Beck; Michael Leunig; Hubert Nötzli; Klaus A Siebenrock Journal: Clin Orthop Relat Res Date: 2003-12 Impact factor: 4.176
Authors: Justin T Smith; Young Jee; Erika Daley; Denise M Koueiter; Martin Beck; Ira Zaltz Journal: Clin Orthop Relat Res Date: 2021-05-01 Impact factor: 4.176
Authors: Joshua D Harris; Richard C Mather; Shane J Nho; John P Salvo; Allston J Stubbs; Geoffrey S Van Thiel; Andrew B Wolff; John J Christoforetti; Thomas J Ellis; Dean K Matsuda; Benjamin R Kivlan; Dominic S Carreira Journal: J Hip Preserv Surg Date: 2019-12-12