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Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar

Year 2021, Volume: 14 Issue: 2, 282 - 290, 25.08.2021
https://doi.org/10.26559/mersinsbd.840586

Abstract

Amaç: Çalışmamızda femoroasetabular sıkışma sendromlu hastalarda klinik sonuçların ve eşlik edebilen pelvik bölgedeki radyolojik değişikliklerin incelenmesi; kalça ağrılarının etyolojisinde femoroasetabular sıkışmanın ve konservatif tedavinin öneminin vurgulanması amaçlanmıştır. Gereç ve Yöntem: Ağustos 2016-Ağustos 2020 tarihleri arasında femoroasetabular sıkışma sendromu tanısı olan 104 hastanın dosya kayıtları ile sosyodemografik ve klinik özellikleri, abdominal ve pelvik bilgisayarlı tomografi taramaları, pelvik bölgenin magnetik rezonans görüntülemeleri retrospektif olarak incelendi. Bulgular: Hastaların %41.3’ü kadın, %58.7’si erkek ve yaş ortalaması 52.78±13.18 idi. Hastaların %37.5’u ev hanımı; %29.8’i çalışmayan; %28.8’i çalışan ve %3.8‘i öğrenciydi. Kalça ağrısı olan hastaların oranı %76 idi. %31.7’sinde sağ kalça; %22.1 sol kalça ve %22.1’inde her iki kalça bölgesinde ağrı şikayeti mevcuttu. Hastaların %17.3’üne aktivite modifikasyonu ve medikal tedavi; %32.7’sinde medikal tedavi ve ev egzersiz programı; %26.0’ünde fizyoterapi uygulanmış; %24.0'ünde herhangi bir tedavi uygulanmamıştı. Hastaların %54.8’ine tomografi; %45.2’sine magnetik rezonans görüntüleme ile tanı konmuştu. Radyografik bulgulara göre %80.8’inde cam tip; %5.8’inde pincer tip ve 13.5’inde mikst tip femoroasetabular sıkışma vardı. Asemptomatik hastaların %53.7’sinde; ağrı şikayeti olan hastaların %61.8’inde pelvik bölgede ek radyolojik değişiklikler vardı. Her iki grupta pelvik bölgede eşlik eden radyolojik değişiklikler en fazla subkortikal kist ve sklerozdu. Sonuç: Kalça osteoartriti gelişiminde önemli faktörlerden birisi olan femoroasetabular sıkışma sendromu kalça ağrısı nedenleri araştırılırken düşünülmelidir. Erken tanı ve etkin tedaviyle kalça ekleminin korunması, hastanın yaşam kalitesinin arttırılması hedeflenmelidir. Bu amaçlarla fizyoterapi semptomatik femoroasetabular sıkışma sendromlu hastalarda tedavi seçeneği olarak düşünülebilir.

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Project Number

yok

References

  • 1. Clohisy JC, Knaus ER, Hunt DM, Lesher MJ, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638-44. doi:10.1007/s11999-008-0680-y
  • 2. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466(2):264-72. doi:10.1007/s11999-007-0060-z
  • 3. Griffin DR, Dickenson EJ, O’Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169-76. doi:10.1136/bjsports 2016096743.
  • 4. Wylie JD, Peters CL, Aoki SK. Natural history of structural hip abnormalities and the potential for hip preservation. J Am Acad Orthop Surg. 2018;26(15):515-25. doi: 10.5435/JAAOS-D-16-00532
  • 5. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012-18. doi: 10.1302/0301-620X.87B7.15203.
  • 6. Bredella MA, Ulbrich EJ, Stoller DW, Anderson SE. Femoroacetabular impingement. Magn Reson Imaging. Clin N Am. 2013;21(1):45-64. doi:10.1016/j.mric.2012.08.012
  • 7. Audenaert EA, Baelde N, Pattyn C, Baelde N, Pattyn C. Hip morphological characteristics and range of internal rotation in femoroacetabular impingement. Am J Sports Med 2012;40(6):1329-36. doi: 10.1177/0363546512441328
  • 8. Amanatullah DF, Antkowiak T, Pillay K, et al. Femoroacetabular impingement: current concepts in diagnosis and treatment. Orthopedics. 2015;38(3):185-99. doi:10.3928/01477447-20150305-07
  • 9. Aoyama M, Ohnishi Y, Utsunomiya H, et al. A prospective, randomized, controlled trial comparing conservative treatment with trunk stabilization exercise to standard hip muscle exercise for treating femoroacetabular impingement: a pilot study. Clin J Sport Med. 2019;29(4):267-75. doi: 10.1097/JSM.0000000000000516
  • 10. Casartelli NC, Bizzini M, Kemp J, Naal FD, Leunig M, Maffiuletti NA. What treatment options exist for patients with femoroacetabular impingement syndrome but without surgical indication? Br J Sports Med. 2018;52(9):552-53. doi:10.1136/bjsports-2017-098059
  • 11. Ayeni OR, Wong I, Chien T, Musahl V, Kelly BT, Bhandari M. Surgical indications for arthroscopic management of femoroacetabular impingement. Arthroscopy 2012;28(8):1170-79. doi: 10.1016/j.arthro.2012.01.010
  • 12. Dwyer T, Whelan D, Shah PS, Ajrawat P, Hoit G, Chahal J. Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes. The Journal of Arthroscopic&Related Surgery. 2020:36(1):236-73. doi: 10.1016/j.arthro.2019.07.025
  • 13. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHION): a multicentre randomised controlled trial. Lancet. 2018;391(18):2225-35. doi:10.1016/S01406736(18)31202-9
  • 14. Hoit G, Whelan DB, Dwyer T, Ajrawat P, and Chahal J. Physiotherapy as an Initial Treatment Option for Femoroacetabular Impingement: A Systematic Review of the Literature and Meta-analysis of 5 Randomized Controlled Trials. The American Journal of Sports Medicine. 2020;48(8):2042-50. doi:10.1177/0363546519882668
  • 15. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis-what the radiologist should konow. AJR Am J Roentgenol. 2007;188(6):1540-52. doi: 10.2214/AJR.06.0921.
  • 16. Trigg SD, Schroeder JD, and Hulsopple C. Femoroacetabular Impingement Syndrome. American College of Sports Medicine 2020;19(9):360-66.doi: 10.1249/JSR.0000000000000748
  • 17. Krishnamoorthy VP, Kunze KN, Beck EC, et al. Radiographic Prevalence of Symphysis Pubis Abnormalities and Clinical Outcomes in Patients With Femoroacetabular Impingement Syndrome. The American Journal of Sports Medicine 2019;47(6):1467-72.doi:10.1177/0363546519837203

Radiologic abnormalities of pelvic area and clinical outcomes in patients with femoroacetabular ımpingement syndrome

Year 2021, Volume: 14 Issue: 2, 282 - 290, 25.08.2021
https://doi.org/10.26559/mersinsbd.840586

Abstract

Aim: In our study, we aimed to examine the clinical outcomes and radiological changes in the pelvic region in patients with femoroacetabular impingement syndrome; to emphasize the importance of femoroacetabular impingement in the etiology of hip pain and conservatif management. Material and Methods: The sociodemographic and clinical characteristics, abdominal and pelvic computed tomography scans, pelvic magnetic resonance imaging of 104 patients diagnosed with femoroacetabular impingement syndrome between August 2016-August 2020 were retrospectively analyzed.Results: 41.3% of the patients were female, 58.7% were male and the mean age was 52.78 ± 13.18. 37.5% of the patients are housewives; 29.8% are not working; 28.8% were working and 3.8% were students. The proportion of patients with hip pain was 76%. 31.7% had pain in the right hip; 22.1% had pain in the left hip and 22.1% in both hip regions. Activity modification and medical therapy for 17.3% of the patients; medical treatment and home exercise program in 32.7%; physiotherapy was applied in 26.0%; no treatment was applied in 24.0%. 54.8% of the patients were diagnosed by tomography and 45.2% of them were diagnosed by magnetic resonance imaging. According to radiological results, 80.8% of them had cam; 5.8% had pincer and 13.5% had mixed type of femoroacetabular impingement. In 53.7% of asymptomatic patients and in 61.8% of the patients with pain complaints had additional radiological changes in the pelvic region. Accompanying radiological changes in the pelvic region were mostly subcortical cysts and sclerosis. Conclusion: Femoroacetabular impingement syndrome, which is one of the important factors in the development of hip osteoarthritis, should be considered when investigating the causes of hip pain. Protection of the hip joint and increasing the patient's quality of life should be aimed with early diagnosis and effective treatment. For these purposes, physiotherapy can be considered as a treatment option in patients with symptomatic femoroacetabular impingement syndrome

Project Number

yok

References

  • 1. Clohisy JC, Knaus ER, Hunt DM, Lesher MJ, Harris-Hayes M, Prather H. Clinical presentation of patients with symptomatic anterior hip impingement. Clin Orthop Relat Res. 2009;467(3):638-44. doi:10.1007/s11999-008-0680-y
  • 2. Ganz R, Leunig M, Leunig-Ganz K, Harris WH. The etiology of osteoarthritis of the hip: an integrated mechanical concept. Clin Orthop Relat Res. 2008;466(2):264-72. doi:10.1007/s11999-007-0060-z
  • 3. Griffin DR, Dickenson EJ, O’Donnell J, et al. The Warwick Agreement on femoroacetabular impingement syndrome (FAI syndrome): an international consensus statement. Br J Sports Med. 2016;50(19):1169-76. doi:10.1136/bjsports 2016096743.
  • 4. Wylie JD, Peters CL, Aoki SK. Natural history of structural hip abnormalities and the potential for hip preservation. J Am Acad Orthop Surg. 2018;26(15):515-25. doi: 10.5435/JAAOS-D-16-00532
  • 5. Beck M, Kalhor M, Leunig M, Ganz R. Hip morphology influences the pattern of damage to the acetabular cartilage: femoroacetabular impingement as a cause of early osteoarthritis of the hip. J Bone Joint Surg Br. 2005;87(7):1012-18. doi: 10.1302/0301-620X.87B7.15203.
  • 6. Bredella MA, Ulbrich EJ, Stoller DW, Anderson SE. Femoroacetabular impingement. Magn Reson Imaging. Clin N Am. 2013;21(1):45-64. doi:10.1016/j.mric.2012.08.012
  • 7. Audenaert EA, Baelde N, Pattyn C, Baelde N, Pattyn C. Hip morphological characteristics and range of internal rotation in femoroacetabular impingement. Am J Sports Med 2012;40(6):1329-36. doi: 10.1177/0363546512441328
  • 8. Amanatullah DF, Antkowiak T, Pillay K, et al. Femoroacetabular impingement: current concepts in diagnosis and treatment. Orthopedics. 2015;38(3):185-99. doi:10.3928/01477447-20150305-07
  • 9. Aoyama M, Ohnishi Y, Utsunomiya H, et al. A prospective, randomized, controlled trial comparing conservative treatment with trunk stabilization exercise to standard hip muscle exercise for treating femoroacetabular impingement: a pilot study. Clin J Sport Med. 2019;29(4):267-75. doi: 10.1097/JSM.0000000000000516
  • 10. Casartelli NC, Bizzini M, Kemp J, Naal FD, Leunig M, Maffiuletti NA. What treatment options exist for patients with femoroacetabular impingement syndrome but without surgical indication? Br J Sports Med. 2018;52(9):552-53. doi:10.1136/bjsports-2017-098059
  • 11. Ayeni OR, Wong I, Chien T, Musahl V, Kelly BT, Bhandari M. Surgical indications for arthroscopic management of femoroacetabular impingement. Arthroscopy 2012;28(8):1170-79. doi: 10.1016/j.arthro.2012.01.010
  • 12. Dwyer T, Whelan D, Shah PS, Ajrawat P, Hoit G, Chahal J. Operative Versus Nonoperative Treatment of Femoroacetabular Impingement Syndrome: A Meta-analysis of Short-Term Outcomes. The Journal of Arthroscopic&Related Surgery. 2020:36(1):236-73. doi: 10.1016/j.arthro.2019.07.025
  • 13. Griffin DR, Dickenson EJ, Wall PDH, et al. Hip arthroscopy versus best conservative care for the treatment of femoroacetabular impingement syndrome (UK FASHION): a multicentre randomised controlled trial. Lancet. 2018;391(18):2225-35. doi:10.1016/S01406736(18)31202-9
  • 14. Hoit G, Whelan DB, Dwyer T, Ajrawat P, and Chahal J. Physiotherapy as an Initial Treatment Option for Femoroacetabular Impingement: A Systematic Review of the Literature and Meta-analysis of 5 Randomized Controlled Trials. The American Journal of Sports Medicine. 2020;48(8):2042-50. doi:10.1177/0363546519882668
  • 15. Tannast M, Siebenrock KA, Anderson SE. Femoroacetabular impingement: radiographic diagnosis-what the radiologist should konow. AJR Am J Roentgenol. 2007;188(6):1540-52. doi: 10.2214/AJR.06.0921.
  • 16. Trigg SD, Schroeder JD, and Hulsopple C. Femoroacetabular Impingement Syndrome. American College of Sports Medicine 2020;19(9):360-66.doi: 10.1249/JSR.0000000000000748
  • 17. Krishnamoorthy VP, Kunze KN, Beck EC, et al. Radiographic Prevalence of Symphysis Pubis Abnormalities and Clinical Outcomes in Patients With Femoroacetabular Impingement Syndrome. The American Journal of Sports Medicine 2019;47(6):1467-72.doi:10.1177/0363546519837203
There are 17 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Articles
Authors

Tuba Erdem Sultanoğlu 0000-0003-0021-5952

Sarfinaz Ataoğlu 0000-0002-0374-0712

Hasan Baki Altınsoy 0000-0003-0934-3600

Hasan Sultanoğlu 0000-0003-4099-572X

Project Number yok
Publication Date August 25, 2021
Submission Date December 14, 2020
Acceptance Date April 1, 2021
Published in Issue Year 2021 Volume: 14 Issue: 2

Cite

APA Erdem Sultanoğlu, T., Ataoğlu, S., Altınsoy, H. B., Sultanoğlu, H. (2021). Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar. Mersin Üniversitesi Sağlık Bilimleri Dergisi, 14(2), 282-290. https://doi.org/10.26559/mersinsbd.840586
AMA Erdem Sultanoğlu T, Ataoğlu S, Altınsoy HB, Sultanoğlu H. Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar. Mersin Univ Saglık Bilim derg. August 2021;14(2):282-290. doi:10.26559/mersinsbd.840586
Chicago Erdem Sultanoğlu, Tuba, Sarfinaz Ataoğlu, Hasan Baki Altınsoy, and Hasan Sultanoğlu. “Femoroasetabular sıkışma Sendromlu Hastalarda Pelvik bölgenin Radyolojik Anormallikleri Ve Klinik sonuçlar”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14, no. 2 (August 2021): 282-90. https://doi.org/10.26559/mersinsbd.840586.
EndNote Erdem Sultanoğlu T, Ataoğlu S, Altınsoy HB, Sultanoğlu H (August 1, 2021) Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14 2 282–290.
IEEE T. Erdem Sultanoğlu, S. Ataoğlu, H. B. Altınsoy, and H. Sultanoğlu, “Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar”, Mersin Univ Saglık Bilim derg, vol. 14, no. 2, pp. 282–290, 2021, doi: 10.26559/mersinsbd.840586.
ISNAD Erdem Sultanoğlu, Tuba et al. “Femoroasetabular sıkışma Sendromlu Hastalarda Pelvik bölgenin Radyolojik Anormallikleri Ve Klinik sonuçlar”. Mersin Üniversitesi Sağlık Bilimleri Dergisi 14/2 (August 2021), 282-290. https://doi.org/10.26559/mersinsbd.840586.
JAMA Erdem Sultanoğlu T, Ataoğlu S, Altınsoy HB, Sultanoğlu H. Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar. Mersin Univ Saglık Bilim derg. 2021;14:282–290.
MLA Erdem Sultanoğlu, Tuba et al. “Femoroasetabular sıkışma Sendromlu Hastalarda Pelvik bölgenin Radyolojik Anormallikleri Ve Klinik sonuçlar”. Mersin Üniversitesi Sağlık Bilimleri Dergisi, vol. 14, no. 2, 2021, pp. 282-90, doi:10.26559/mersinsbd.840586.
Vancouver Erdem Sultanoğlu T, Ataoğlu S, Altınsoy HB, Sultanoğlu H. Femoroasetabular sıkışma sendromlu hastalarda pelvik bölgenin radyolojik anormallikleri ve klinik sonuçlar. Mersin Univ Saglık Bilim derg. 2021;14(2):282-90.

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