Expressiveness and frequency differences of hip joint tissues pathomorphological changes in diseases complicated by femoroacetabular impingement syndrome

Authors

  • V. V. Grigorovsky ДУ «Інститут травматології та ортопедії Національної академії медичних наук України»,
  • V. V. Filipchuk ДУ «Інститут травматології та ортопедії Національної академії медичних наук України»,
  • M. S. Kabatsiy ДУ «Інститут травматології та ортопедії Національної академії медичних наук України»,

DOI:

https://doi.org/10.14739/2310-1237.2013.3.22703

Keywords:

femoroacetabular impingement, femoral head aseptic necrosis, juvenile epiphyseolysis, pathomorphological changes, frequency analysis

Abstract

Preface. Last years the increasing value in pathogenesis of hip joint osteoarthrosis (ОА) both in adult patients and in children and teenagers is attached to articular surfaces congruence violation of the femoral head and acetabulum that is formed by articular cartilage and labrum, the last one by head movements in the maximum hip flexion and adduction enters in femoroacetabular impingement (FAI) with edge of the head and allied site of the neck and is mechanically damaged.

Purpose of the work. To establish hip joint tissues pathomorphological changes, to which FAI syndrome leads, and on the basis of graded expressiveness quantification of pathological changes to define differences of their occurrence frequency in groups of patients in some diseases with affected hip joint.

Materials and research methods. 65 biopsies of hip joint tissues: proximal femoral epimetaphysis, acetabulum, acetabular lip and joint capsule –from patients with aseptic femoral head necrosis (АNFH) and juvenile slipped femoral capital epiphysis (JSFCE). After study of qualitative features of hip joint tissues injury, some graded morphological indices characterizing conditions of affected joints, as occurrence frequencies of pathological changes of certain gradation, and also their comparison in groups of monitoring with calculation of their distinctions significance, were estimated.

Results and their discussion. Clinical-pathomorphological research has revealed the various pathological changes shown by signs of discirculatory, chronic dystrophic-destructive and inflammatory processes in tissues of the femoral head, neck, acetabulum and joint capsule.

FAI, causing secondary dystrophic-destructive changes in hip joint tissues, has different rates of development in various primary pathology: in JSCFE anatomic conditions of FAI develop faster, in АNFH – more slowly in the dynamics of secondary changes, the last ones do not differ statistically in various nosologies on rates of the development of symptoms leading to the necessity of correcting operations on the joint.

Degrees of "femoral head articular surface deformation" in various nosologies essentially differ on frequency of occurrence of cases with certain expressiveness: if in patients with JSFCE only low degree of femoral head deformation occurs, in АNFH cases with high degree of expressiveness comprise over one third, that is connected, probably, with features of the basic pathological processes in femoral head spongiosa in this disease.

Occurrence frequency of nonspecific synovitis cases of certain activity degree depends from primary nosology which has become complicated by FAI: among patients with АNFH synovitis of average or high degree was found significantly more frequent, than among patients with JSFCE in whom cases of low activity synovitis prevail.

Conclusions. In the present work comparative research of all hip joint tissues was performed for the first time on rather big clinical-morphological material, with application of graded indices and the frequency analysis, degrees of  pathological changes expressiveness are defined and distinctions of frequencies of occurrence in groups of comparison of patients with АNFH and JSFCE, complicated by FAI, were established.

 

References

Григоровский В.В. Патоморфологические изменения в тканях тазобедренного сустава детей и подростков и некоторые клинико-морфологические зависимости при последствиях асептического некроза, юношеского эпифезеолиза и хондролиза головки бедра / В.В. Григоровский, М.С. Кабаций, В.В. Филипчук // Травматология и ортопедия России. – СПб., 2008. – № 3. – С. 20–29.

Григоровський В.В. Патоморфологічні особливості ураження тканин кульшового суглоба та деякі клініко-морфологічні залежності при різних видах варусної деформації проксимального кінця стегнової кістки у дітей та підлітків / В.В. Григоровський, М.С. Кабацій, В.В. Філіпчук, Д.М. Мороз // Вісник ортопедії, травматології та протезування. – К., 2011. – № 2. – С. 61–66.

Вardakos I.V. Predictors of progression of osteoarthritis in femoroacetabular impingement. A radiological study with a minimum of ten years follow-up / I.V. Bardakos, R.N. Villar // J. Bone and Joint Surg. – 2009. – V. 91-B. – №. 2. – P. 162 169.

Beck M. Hip morphology infl uences the pattern of damage to the acetabular cartilage. Femoroacetabular impingement as a cause of early osteoarthritis of the hip / M. Beck, M. Kalhor, M. Leunig, R. Ganz // J. Bone and Joint Surg. – 2005. – V. 87- B. – № 7. – P. 1012–1018.

Corten K. Bone Apposition of the acetabular rim in deep hips. A distinct fi nding of global pincer impingement / K. Corten, R. Ganz, E. Chosa, M. Leunig // J. Bone and Joint Surg. – 2011. – V. 93-А. – Suppl. 2. – P. 10–16.

Dodds M.K. Femoroacetabular impingement after slipped capital femoral epiphysis: does slip severity predict clinical symptoms? / M.K. Dodds, D. McCormack, K.J. Mulhall // J. Pediatr. Orthop. – 2009. – V. 29. – № 6. – P. 535–539.

Ganz R. The Etiology of Osteoarthritis of the Hip / R. Ganz, M. Leunig, K. Leunig-Ganz, W.H. Harris // Clin. Orthop. Rel. Res. – 2008. – V. 466. – P. 264–272.

Grant A.D. The labrum: structure, function, and injury with femoro-acetabular impingement / A.D. Grant, D.A. Sala, R.I. Davidovitch // J. Child. Orthop. – 2012. – 16 p.

Ito K. Histopathologic features of the acetabular labrum in femoroacetabular impingement / K. Ito, M. Leunig, R. Ganz // Clin. Orthop. Rel. Res. – 2004. – № 429. – P. 262–271.

Konan S. Validation of the classifi cation system for acetabular chondral lesions identifi ed at arthroscopy in patients with femoroacetabular impingement / S. Konan, F. Rayan, G. Meermans, J. Witt, F.S. Haddad // J. Bone and Joint Surg. – 2011. – V. 93-B. – № 3. – P. 332–336.

Lerch S. Evaluation of Cam-type femoroacetabular impingement by ultrasound / S. Lerch, A. Kasperczyk, J. Warnecke, Th. Berndt, O. Rьhmann // Int. Orthop. – 2013. – V. 37. – № 5. – P. 783–788.

Leunig M. The Concept of Femoroacetabular Impingement: Current Status and Future Perspectives / M. Leunig, P.E. Beaulй, R. Ganz // Clin Orthop Relat Res. – 2009. – V. 467. – № 3. – P. 616–622.

Masjedi M. The three-dimensional relationship between acetabular rim morphology and the severity of femoral cam lesions / M. Masjedi, C.L. Nightingale, D.Y. Azimi, J.P. Cobb // Bone Joint Journ. – 2013. – V. 95-B. – № 3. – P. 314–319.

Monazzam S. Development prevalence of femoroacetabular impingement-associated morphology in a paediatric and adolescent population. A CT study of 225 patients / S. Monazzam, J.D. Bomar, J.R. Dwek, H.S. Hosalkar, A.T. Pennock // Bone Joint J. – 2013. – V. 95-B. – № 5. – P. 598–604.

Reid G.D. Femoroacetabular impingement syndrome: an underrecognized cause of hip pain and premature osteoarthritis? / G.D. Reid, C.G. Reid, N. Widmer, P.L. Munk // J. Rheumatol. – 2010. – V. 37. – № 7. – P. 1395–1404.

Siebenrock K.A. Experimentally induced cam impingement in the sheep hip / K.A. Siebenrock, R. Fiechter, M. Tannast, T.C. Mamisch, B. von Rechenberg // J Orthop. Res. – 2013. – V. 31. – № 4. – P. 580–587.

Tibor L.M. The pathoanatomy and arthroscopic management of femoroacetabular impingement / L.M. Tibor, M. Leunig // Bone Joint Res. – 2012. –№ 1. – P. 245–257.

Wensaas A. Femoroacetabular impingement after slipped femoral epiphysis. The radiological diagnosis and clinical outcome at long-term follow-up / A. Wensaas, R.B. Gunderson, S. Svenningsen, T. Terjesen // J. Bone Joint Surg. – 2012. – V. 94-B. – № 11. – P. 1487–1493.

How to Cite

1.
Grigorovsky VV, Filipchuk VV, Kabatsiy MS. Expressiveness and frequency differences of hip joint tissues pathomorphological changes in diseases complicated by femoroacetabular impingement syndrome. Pathologia [Internet]. 2014Mar.5 [cited 2024Nov.23];(3). Available from: http://pat.zsmu.edu.ua/article/view/22703

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Original research