Acetabular retroversion in military recruits with femoral neck stress fractures

Kevin M. Kuhn, Anthony I. Riccio, Nelson S. Saldua, Jeffrey Cassidy

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the anteroposterior (AP) pelvic radiographs of 54 patients (108 hips) treated for a femoral neck stress fracture (FNSF) and compared these radiographs with those for a control group of patients with normal pelvic radiographs. We determined presence of a crossover sign (COS), femoral neck abnormalities, and neck shaft angle. The prevalence of a positive COS was greater in patients with stress fractures than in the control subjects (31 of 54 [57%] versus 17 of 54 [31%], respectively) and higher than for control subjects reported in the literature. Thirteen patients had radiographic changes of the femoral neck consistent with femoroacetabular impingement (FAI). These radiographic abnormalities were seen more commonly in retroverted hips. A greater incidence of AR was noted in patients with FNSF. Potential implications include more aggressive screening of military recruits with AR and the new onset of hip pain. Finally, we present an algorithm we use to diagnose and treat these relatively rare FNSFs. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)846-851
Number of pages6
JournalClinical Orthopaedics and Related Research
Volume468
Issue number3
DOIs
StatePublished - Mar 1 2010

Fingerprint

Stress Fractures
Femoral Neck Fractures
Hip
Femur Neck
Femoracetabular Impingement
Neck
Guidelines
Pain
Control Groups
Incidence
Wounds and Injuries

ASJC Scopus subject areas

  • Orthopedics and Sports Medicine

Cite this

Acetabular retroversion in military recruits with femoral neck stress fractures. / Kuhn, Kevin M.; Riccio, Anthony I.; Saldua, Nelson S.; Cassidy, Jeffrey.

In: Clinical Orthopaedics and Related Research, Vol. 468, No. 3, 01.03.2010, p. 846-851.

Research output: Contribution to journalArticle

Kuhn, Kevin M. ; Riccio, Anthony I. ; Saldua, Nelson S. ; Cassidy, Jeffrey. / Acetabular retroversion in military recruits with femoral neck stress fractures. In: Clinical Orthopaedics and Related Research. 2010 ; Vol. 468, No. 3. pp. 846-851.
@article{6351fb84993d45a8b92988e3918be3ad,
title = "Acetabular retroversion in military recruits with femoral neck stress fractures",
abstract = "Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the anteroposterior (AP) pelvic radiographs of 54 patients (108 hips) treated for a femoral neck stress fracture (FNSF) and compared these radiographs with those for a control group of patients with normal pelvic radiographs. We determined presence of a crossover sign (COS), femoral neck abnormalities, and neck shaft angle. The prevalence of a positive COS was greater in patients with stress fractures than in the control subjects (31 of 54 [57{\%}] versus 17 of 54 [31{\%}], respectively) and higher than for control subjects reported in the literature. Thirteen patients had radiographic changes of the femoral neck consistent with femoroacetabular impingement (FAI). These radiographic abnormalities were seen more commonly in retroverted hips. A greater incidence of AR was noted in patients with FNSF. Potential implications include more aggressive screening of military recruits with AR and the new onset of hip pain. Finally, we present an algorithm we use to diagnose and treat these relatively rare FNSFs. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.",
author = "Kuhn, {Kevin M.} and Riccio, {Anthony I.} and Saldua, {Nelson S.} and Jeffrey Cassidy",
year = "2010",
month = "3",
day = "1",
doi = "10.1007/s11999-009-0969-5",
language = "English (US)",
volume = "468",
pages = "846--851",
journal = "Clinical Orthopaedics and Related Research",
issn = "0009-921X",
publisher = "Springer New York",
number = "3",

}

TY - JOUR

T1 - Acetabular retroversion in military recruits with femoral neck stress fractures

AU - Kuhn, Kevin M.

AU - Riccio, Anthony I.

AU - Saldua, Nelson S.

AU - Cassidy, Jeffrey

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the anteroposterior (AP) pelvic radiographs of 54 patients (108 hips) treated for a femoral neck stress fracture (FNSF) and compared these radiographs with those for a control group of patients with normal pelvic radiographs. We determined presence of a crossover sign (COS), femoral neck abnormalities, and neck shaft angle. The prevalence of a positive COS was greater in patients with stress fractures than in the control subjects (31 of 54 [57%] versus 17 of 54 [31%], respectively) and higher than for control subjects reported in the literature. Thirteen patients had radiographic changes of the femoral neck consistent with femoroacetabular impingement (FAI). These radiographic abnormalities were seen more commonly in retroverted hips. A greater incidence of AR was noted in patients with FNSF. Potential implications include more aggressive screening of military recruits with AR and the new onset of hip pain. Finally, we present an algorithm we use to diagnose and treat these relatively rare FNSFs. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

AB - Acetabular retroversion (AR) alters load distribution across the hip and is more prevalent in pathologic conditions involving the hip. We hypothesized the abnormal orientation and mechanical changes may predispose certain individuals to stress injuries of the femoral neck. We retrospectively reviewed the anteroposterior (AP) pelvic radiographs of 54 patients (108 hips) treated for a femoral neck stress fracture (FNSF) and compared these radiographs with those for a control group of patients with normal pelvic radiographs. We determined presence of a crossover sign (COS), femoral neck abnormalities, and neck shaft angle. The prevalence of a positive COS was greater in patients with stress fractures than in the control subjects (31 of 54 [57%] versus 17 of 54 [31%], respectively) and higher than for control subjects reported in the literature. Thirteen patients had radiographic changes of the femoral neck consistent with femoroacetabular impingement (FAI). These radiographic abnormalities were seen more commonly in retroverted hips. A greater incidence of AR was noted in patients with FNSF. Potential implications include more aggressive screening of military recruits with AR and the new onset of hip pain. Finally, we present an algorithm we use to diagnose and treat these relatively rare FNSFs. Level of Evidence: Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.

UR - http://www.scopus.com/inward/record.url?scp=77449151866&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77449151866&partnerID=8YFLogxK

U2 - 10.1007/s11999-009-0969-5

DO - 10.1007/s11999-009-0969-5

M3 - Article

C2 - 19588210

AN - SCOPUS:77449151866

VL - 468

SP - 846

EP - 851

JO - Clinical Orthopaedics and Related Research

JF - Clinical Orthopaedics and Related Research

SN - 0009-921X

IS - 3

ER -