Proof of concept: hip joint damage occurs at the zone of femoroacetabular impingement (FAI) in an experimental FAI sheep model

Abstract

Objective: In ovine hips chondrolabral damage as seen in cam-type femoroacetabular impingement (FAI) can be induced via an intertrochanteric varus osteotomy. However, it is yet to proven whether the observed cartilage damage is caused by a dynamic cam type impingement. Thus we asked, (1) whether actual cartilage damage observed after FAI induction in ovine hips occurs at the predicted, computed zone of FAI; (2) whether the extent of cartilage damage increases with ambulation time in this animal model?

Design: In this experimental, controlled, comparative study 20 sheep underwent unilateral FAI induction through an intertrochanteric varus osteotomy. Preoperatively sheep underwent computed tomography to generate three-dimensional models of the osseous pelvis and femur. The models were used to predict impingement zones before and after simulated varus osteotomy using range of motion (ROM) analysis. Sheep were sacrificed after 14-40 weeks of ambulation. At sacrifice cartilage was inspected and (1) location of actual damage and computed impingement zones were compared; (2) Cartilage damage was compared between short- and long ambulation groups.

Results: (1) The average location and the extent of peripheral and central cartilage lesions did not differ with the computed impingement zones (all P > 0.05). (2) Grades of central, posterior cartilage damage were more severe in the long-compared to the short ambulation group (2.2 ± 1.8 vs 0.4 ± 0.5; P = 0.030).

Conclusions: In this experimental ovine FAI model the surgical induction of an osseous impingement conflict between the femur and acetabulum causes cartilage damage at the zone of simulated FAI.

Keywords: CT impingement simulation; Cam deformity; Femoroacetabular impingement; Hip preservation surgery; Osteoarthritis; Sheep hip model.