Correlation Between Internal Rotation and Bony Anatomy in the Hip

Abstract

Femoroacetabular impingement has been implicated as a risk factor for degenerative arthritis in young people with normally concentric hips. On presentation, patients with impingement have groin pain, limited internal rotation in 90 degrees flexion, and focal articular lesions. We hypothesized that the amount of internal rotation is dictated primarily by the underlying bony anatomy and not secondary to contractures. We compared 23 consecutive patients (32 hips) with 40 asymptomatic control subjects using positional magnetic resonance imaging, physical examination, and a questionnaire regarding symptoms and their commencement. There was a strong correlation between internal rotation in 90 degrees flexion and the measurable free space between the relevant bony contours on magnetic resonance imaging (r = 0.97) in the patient group and the control subjects. The range of internal rotation is closely related to skeletal anatomy, and internal rotation can be used as a noninvasive tool to predict the risk of impingement.