Sw i s s M e d i c a l We e k l y

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24 Jun 2011 – creativecommons.org/licenses/by-nc- nd/2.5/ch/deed. ...... Of 41 patients involved in sports, 37 (90%) were able to return at the same level, ...

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• Sport

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• Publié par: Sportif
• Nombre de lectures: 130
• Langue: Français

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Established in 1871 S wiss Medical Weekly Formerly: Schweizerische Medizinische Wochenschrift Supplementum 186 The European Journal of Medical Sciences ad Swiss Med Wkly 2011;141 June 10, 2011 Congrès annuel de la Société Suisse d’Orthopédie et de Traumatologie Lausanne (Switzerland), 22–24 June 2011 Supported by the Swiss Academy of Medical Sciences (SAMS), the FMH (Swiss Medical Association) and by Schwabe AG, the long-established scientific publishing house founded in 1488 Official journal of the Swiss Society of Infectious Diseases, Editores Medicorum Helveticorum the Swiss Society of Internal Medicine and the Swiss Respiratory Society1 S SWiSS Med Wkl y 2011;141(Suppl 186) · www.smw.ch Ta ble of contents Suppl. 186 Free communications 2 S ad Swiss Med Wkly 2011;141 June 10, 2011 Abstracted / indexed in © EMH Swiss Medical Publishers Ltd. Creative Commons summary: http:// Head of publications Index Medicus / MEDLINE (EMH), 2011. The Swiss Medical Weekly creativecommons.org/licenses/by-nc- Natalie Marty, MD ([e-mail]) Web of science is an open access publication of EMH. nd/2.5/ch/deed.en_GB; full licence: Managing editor Current Contents Accordingly, EMH grants to all users on http://creativecommons.org/licenses/ Nadine Leyser, PhD ([e-mail]) Science Citation Index the basis of the Creative Commons license by-nc-nd/2.5/ch/legalcode.de EMBASE “Attribution – Non commercial – No Papers administrator All communications to: Derivative Works” for an unlimited pe- Gisela Wagner ([e-mail]) Guidelines for authors EMH Swiss Medical Publishers Ltd. riod the right to copy, distribute, display, The Guidelines for authors are published Swiss Medical Weekly Language editors and perform the work as well as to make it on our website www.smw.ch Farnsburgerstrassse 8 Thomas Brink, MD; Kirsten Clift; publicly available on condition that (1) the Submission to this journal proceeds CH-4132 Muttenz, Switzerland Judith Lutz-Burns, MD; Roy Tu rnill, MA work is clearly attributed to the author or totally on-line: Phone [phone] licensor (2) the work is not used for com- ISSN printed version: 1424-7860 www.smw.ch 3 For Authors Fax [phone] mercial purposes and (3) the work is not ISSN online version: 1424–3997 [e-mail] altered, transformed, or built upon. Any Regular subscription price for 2011: use of the work for commercial purposes CHF 150.– (shipping not included) needs the explicit prior authorisation of EMH on the basis of a written agreement. 12 print issues per year; continuous online publication2 S Free communications SWiSS Med Wkly 2011;141(Suppl 186) · www.smw.ch FM 1 FM 3 The Ligamentum Capitis Femoris – HIP ARTHROSCOPY VERSUS SURGICAL HIP An Arthroscopic Evaluation of Function in Situ DISLOCATION FOR FEMOROACETABULAR IMPINGEMENT 1 2 (FAI): RESULTS OF A PROSPECTIVE COMPARATIVE STUDY Dr. med. univ. Stefan Neuhüttler , Dr. med. Christoph Lampert , 2 1 1 2 Dr. med. Miscia Vincenti , Ao. Univ. Prof. Dr., MME (Bern) Erich Dr. Tobias Bühler , Dr. Patrick Zingg , Dr. Fabian Kalberer , 3 1 Brenner PD Dr. Claudio Dora 1 2 1 2 Kantonsspital St. Gallen; Kantonsspital St. Gallen Klinik für orthopä- Uniklinik Balgrist, Zürich; Orthopädie, Kantonsspital Winterthur, 3 dische Chirurgie; Medizinische Universität Innsbruck, Departement Winterthur für Anatomie, Histologie und Embryologie, Sektion für klinisch- Background: Surgical treatment of femoroacetabular impingement funktionelle Anatomie (FAI) is either performed by surgical hip dislocation (SHD) or by Introduction: Reviewing the literature there’s evidence that lesons arthroscopy (HAS). There are no comparative studies assessing the of the ligamentum capitis femoris (LCF) can have quite a pathologic quality of morphological correction, rehabilitation time, morbidity or value. By now the arthroscopically performed reduction, resection or short-term outcome. The aim of the present study was to compare trimming of ruptured or injured ligaments that cause impingement are radiological and clinical outcome after SHD and HAS. state of the art. Latest examinations of the ligament found similarities Methods: Between 2007 and 2009, 38 patients (23 HAS, 15 SHD) to the ACL, whereas one can separate three different bundles in the were included in a prospective, partially randomized study with stan- LCF compared to two in the ACL. These findings lead to the question dardized follow-up examination at 6 weeks, 3 and 12 months. The whether reconstructions of the LCF are worth to be considered. As amount of acetabular and femoral bony resection was measured on there’s nothing known about the definite function of the LCF in adults X-rays and on radial reformations of MRT (7 sectors within the antero- we performed this study to gain more information about this topic. superior quadrant) by assessment of the angle a, the crossover sign Material and Methods: Cadaver hips were prepared down to joint and the acetabular coverage angle. To compare the clinical outcome, capsule and bone. Parts of the lamina quadrangularis were removed the Harris Hip (HHS) and WOMAC score as well as pain (VAS), the by means either of hammer and chisel or high speed cutters to open subjective hip value (SHV), and the period of incapacity to work were the fossa from the plevic side. 30° and 70° angled optics were used to assessed. In addition, the amount of internal rotation and abduction examine the performance of the LCF during different movements of strength was measured. the joint. Results: The mean age was 28 years (range 18–46). Neither the Results: Every different form of appearance of the LCF described in extent of preoperative bony deformity nor the demographic data (age, the literature (ovaloid, flat, round, ....) could be found during different gender, BMI, profession) differed between the groups. The postopera- movements of the hip joint.We couldn’t separate three different bund- tive measurements on MRT and on cross-table views were equivalent. les, we could proof a “continuous recruitment of fibres” when taking The length of hospital stay was shorter after HAS (3 vs 5 days, different positions; in nearly every movement of the joint parts of the p <.001). The HHS was higher after HAS at 6 weeks (81 vs 55, p <.001), LCF get tightened. As already known the LCF gets the highest tension 3 months (92 vs 80, p = .038) and 12 months (93 vs 84, p = .030). in flexion-adduction-external rotation and in extension-abduction-exter- Likewise, the WOMAC score after 3 months (0.9 vs 2.3, p = .024) and nal rotation of the hip. The most unstressening position for the LCF is the subscale for pain after 12 months (0.8 vs 2.2, p = .010) was higher. in 0° rotation (extension or flexion), whereas every kind of rotation Following HAS, patients had less pain during activities of daily living (internal or external) tightens different sections of the LCF. The more after 3 months (13 vs 25, p = .038). SHV was higher after HAS at 6 the rotation gets, the more fibres get recruited. weeks (71% vs 47%, p <.001) and 3 months (83% vs 69%, p = .018) Summary: The described technique of examining the LCF offers the while abduction was stronger after 3 (p <.001) and 12 months opportunity to see and evaluate the actions of