Making a case for anterior inferior iliac spine/subspine hip impingement: three representative case reports and proposed concept.

Minnesota Orthopedic Sports Medicine Institute at Twin Cities Orthopedics, Edina, 55435, USA.
Arthroscopy The Journal of Arthroscopic and Related Surgery (Impact Factor: 3.19). 12/2011; 27(12):1732-7. DOI: 10.1016/j.arthro.2011.10.004
Source: PubMed

ABSTRACT Femoroacetabular impingement is typically described as occurring due to a conflict between the femoral head-neck junction and acetabular rim. A prior case report described an open decompression of the anterior inferior iliac spine (AIIS) due to impingement against the proximal femur. AIIS impingement may be developmental or the result of a prior AIIS avulsion or pelvic osteotomy. We describe 3 representative cases with minimum 1-year follow-up treated with an arthroscopic AIIS decompression.

  • [Show abstract] [Hide abstract]
    ABSTRACT: The clock face has been employed to define the position of labral pathology in relation to identifiable arthroscopically relevant acetabular landmarks. The purpose of this study was to qualitatively and quantitatively describe arthroscopically relevant anatomy of the acetabulum. We aimed to present a surgical landmark that is located in close proximity to the usual location of labral pathology as an alternative to the midpoint of the transverse acetabular ligament as a reference point.
    The Journal of Bone and Joint Surgery 10/2014; 96(20):1673-82. DOI:10.2106/JBJS.M.01502 · 4.31 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: This study aimed to define the footprint of the direct and reflected heads of the rectus femoris and the relation of the anterior inferior iliac spine (AIIS) to adjacent neurovascular (lateral circumflex femoral artery and femoral nerve), bony (anterior superior iliac spine [ASIS]), and tendinous structures (iliopsoas). Twelve fresh-frozen cadaveric hip joints from 6 cadavers, average age of 44.5 (±9.9) years, were carefully dissected of skin and fascia to expose the muscular, capsular, and bony structures of the anterior hip and pelvis. Using digital calipers, measurements were taken of the footprint of the rectus femoris on the AIIS, superior-lateral acetabulum and hip capsule, and adjacent anatomic structures. The average dimensions of the footprint of the direct head of the rectus femoris were 13.4 mm (±1.7) × 26.0 mm (±4.1), whereas the dimensions of the reflected head footprint were 47.7 mm (±4.4) × 16.8 mm (±2.2). Important anatomic structures, including the femoral nerve, psoas tendon, and lateral circumflex femoral artery, were noted in proximity to the AIIS. The neurovascular structure closest to the AIIS was the femoral nerve (20.8 ± 3.4 mm). The rectus femoris direct and reflected heads originate over a broad area of the anterolateral pelvis and are in close proximity to critical neurovascular structures, and care must be taken to avoid them during hip arthroscopy. A thorough knowledge of the anatomy of the proximal rectus femoris is valuable for any surgical exposure of the anterior hip joint, particularly arthroscopic subspine decompression and open femoroacetabular impingement (FAI) surgery.
    Arthroscopy The Journal of Arthroscopic and Related Surgery 05/2014; 30(7). DOI:10.1016/j.arthro.2014.03.003 · 3.19 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Hip pain is a common problem in adult athletes and may be caused by a wide range of acute and chronic injuries, many of which lead to prolonged time away from sport. This article highlights the magnetic resonance imaging (MRI) findings of important hip injuries in adult athletes, including select osseous, impingement, intra-articular, and musculotendinous injuries. The most commonly affected athletes, clinical presentation, and MRI findings of each injury are reviewed with corresponding clinical pearls from the orthopedist’s perspective.
    06/2014; 2(6). DOI:10.1007/s40134-014-0051-2