Cargando…

The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space

Background: Pelvi-femoral conflicts are increasingly recognized for their explanatory role in the pathology of extra-articular hip impingement. Ischiofemoral impingement (IFI) is a type of impingement between the femur and the ischium that causes high femoral antetorsion and valgus femoral neck orie...

Descripción completa

Detalles Bibliográficos
Autores principales: Ahmad, Sufian S., Konrads, Christian, Niemann, Marcel, Stöckle, Ulrich, Windhagen, Henning, Giebel, Gregor M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968236/
https://www.ncbi.nlm.nih.gov/pubmed/36836138
http://dx.doi.org/10.3390/jcm12041603
_version_ 1784897464227069952
author Ahmad, Sufian S.
Konrads, Christian
Niemann, Marcel
Stöckle, Ulrich
Windhagen, Henning
Giebel, Gregor M.
author_facet Ahmad, Sufian S.
Konrads, Christian
Niemann, Marcel
Stöckle, Ulrich
Windhagen, Henning
Giebel, Gregor M.
author_sort Ahmad, Sufian S.
collection PubMed
description Background: Pelvi-femoral conflicts are increasingly recognized for their explanatory role in the pathology of extra-articular hip impingement. Ischiofemoral impingement (IFI) is a type of impingement between the femur and the ischium that causes high femoral antetorsion and valgus femoral neck orientation. It is unknown whether obstetric adaptation of the female pelvis renders the female hip at a higher risk of sustaining IFI. The aim of this study was to determine the influence of the pelvic morphology on the ischiofemoral space (IFS). Methods: Plain radiographs of healthy individuals with no symptomatic hip disease were obtained in a functional standing position in a standardized manner and utilized for measurement of the interischial and ischiofemoral widths, subpubic angle, and centrum collum diaphyseal (CCD) angle. Linear regression was performed to determine the influence of morphometric measures on the ischiofemoral space. Results: Sixty-five radiographs (34 females and 31 males) were included. The cohort was stratified according to gender. Significant gender-related differences were noted regarding the ischiofemoral distance (31% increase in males, p < 0.001), pubic-arc angle (30% increased in females, p < 0.001), and the interischial space (7% increase in females, p < 0.001). CCD did not significantly differ between genders (p = 0.2). Factors influencing the IFS include the pubic-arc angle (β = −0.01 (CI −0.02–−0.00), p = 0.003), interischial distance (β = −0.11 (CI −0.23–−0.00), p = 0.049) and CCD (β = −0.06 (CI −0.09–−0.04), p < 0.001). Conclusions: Obstetric adaptation is associated with an increased subpubic angle that shifts the ischia laterally and away from the symphysis. The resultant reduction in the ischiofemoral space renders the female pelvis at a higher risk for a pelvi-femoral conflict, or more precisely, an ischiofemoral conflict, due to the reduced ischiofemoral space of the hip. The CCD angle of the femur was shown not to be gender specific. However, the CCD angle demonstrates an influence on the ischiofemoral space, rendering the proximal femur a target for corresponding osteotomies.
format Online
Article
Text
id pubmed-9968236
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-99682362023-02-27 The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space Ahmad, Sufian S. Konrads, Christian Niemann, Marcel Stöckle, Ulrich Windhagen, Henning Giebel, Gregor M. J Clin Med Article Background: Pelvi-femoral conflicts are increasingly recognized for their explanatory role in the pathology of extra-articular hip impingement. Ischiofemoral impingement (IFI) is a type of impingement between the femur and the ischium that causes high femoral antetorsion and valgus femoral neck orientation. It is unknown whether obstetric adaptation of the female pelvis renders the female hip at a higher risk of sustaining IFI. The aim of this study was to determine the influence of the pelvic morphology on the ischiofemoral space (IFS). Methods: Plain radiographs of healthy individuals with no symptomatic hip disease were obtained in a functional standing position in a standardized manner and utilized for measurement of the interischial and ischiofemoral widths, subpubic angle, and centrum collum diaphyseal (CCD) angle. Linear regression was performed to determine the influence of morphometric measures on the ischiofemoral space. Results: Sixty-five radiographs (34 females and 31 males) were included. The cohort was stratified according to gender. Significant gender-related differences were noted regarding the ischiofemoral distance (31% increase in males, p < 0.001), pubic-arc angle (30% increased in females, p < 0.001), and the interischial space (7% increase in females, p < 0.001). CCD did not significantly differ between genders (p = 0.2). Factors influencing the IFS include the pubic-arc angle (β = −0.01 (CI −0.02–−0.00), p = 0.003), interischial distance (β = −0.11 (CI −0.23–−0.00), p = 0.049) and CCD (β = −0.06 (CI −0.09–−0.04), p < 0.001). Conclusions: Obstetric adaptation is associated with an increased subpubic angle that shifts the ischia laterally and away from the symphysis. The resultant reduction in the ischiofemoral space renders the female pelvis at a higher risk for a pelvi-femoral conflict, or more precisely, an ischiofemoral conflict, due to the reduced ischiofemoral space of the hip. The CCD angle of the femur was shown not to be gender specific. However, the CCD angle demonstrates an influence on the ischiofemoral space, rendering the proximal femur a target for corresponding osteotomies. MDPI 2023-02-17 /pmc/articles/PMC9968236/ /pubmed/36836138 http://dx.doi.org/10.3390/jcm12041603 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Ahmad, Sufian S.
Konrads, Christian
Niemann, Marcel
Stöckle, Ulrich
Windhagen, Henning
Giebel, Gregor M.
The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title_full The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title_fullStr The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title_full_unstemmed The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title_short The Female Pelvis Is Associated with a Lateralized Ischium and a Reduced Ischiofemoral Space
title_sort female pelvis is associated with a lateralized ischium and a reduced ischiofemoral space
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9968236/
https://www.ncbi.nlm.nih.gov/pubmed/36836138
http://dx.doi.org/10.3390/jcm12041603
work_keys_str_mv AT ahmadsufians thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT konradschristian thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT niemannmarcel thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT stockleulrich thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT windhagenhenning thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT giebelgregorm thefemalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT ahmadsufians femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT konradschristian femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT niemannmarcel femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT stockleulrich femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT windhagenhenning femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace
AT giebelgregorm femalepelvisisassociatedwithalateralizedischiumandareducedischiofemoralspace