Differences in the association of hip cartilage lesions and cam-type femoroacetabular impingement with movement patterns: a preliminary study

Objective: To investigate the differences in hip movement patterns during different daily and athletic activities in persons with cam-type femoroacetabular impingement (FAI) with and without cartilage lesions compared with control subjects in a preliminary study.

Design: Controlled laboratory study using a cross-sectional design.

Setting: Research institution with a tertiary care medical center.

Participants: Fifteen subjects [M:F, 13:2; age, 31.6 ± 9.7 years (range, 22-52 years); body mass index, 24.9 ± 4.6 (range, 18.8-38.4); FAI:control, 7:8].

Methods: All subjects had 3-Tesla magnetic resonance imaging of the hip and also underwent 3-dimensional motion capture during walking, deep-squat, and drop-landing tasks. Experienced radiologists graded cartilage lesions on clinical magnetic resonance images.

Outcomes: Peak kinematic and kinetic variables were compared between subjects who did and did not have FAI, and subjects who had FAI and cartilage lesions were compared with subjects who did not have cartilage lesions.

Results: Subjects who had FAI demonstrated no significant differences for walking or drop landing compared with control subjects. However, during the deep-squat task, subjects with FAI adducted more and had a greater internal rotation moment. Subjects who had cartilage lesions in the presence of a cam lesion demonstrated (1) no difference for walking; (2) greater adduction, greater internal rotation moment, and lower transverse plane range of motion during the deep-squat task; and (3) greater adduction and lower internal rotation during the drop-landing task compared with subjects who did not have cartilage lesions.

Conclusions: We observed differences in movement patterns between subjects who had FAI compared with control subjects. However, the differences were more pronounced between subjects with FAI who had cartilage lesions compared with subjects who did not have cartilage lesions. These findings highlight the importance of understanding the complex interplay between bony morphologic features, cartilage lesions, and movement patterns in persons with cam-type FAI.