EP1.30 Sagittal Pelvic Kinematics Impact Femoroacetabular Motion and Hip Joint Biomechanics: A Systematic Review

Purpose: The purpose of this investigation was to perform a systematic review of studies evaluating the effect of pelvic tilt on hip joint contact forces and range of motion in patients with femoroacetabular impingement and acetabular dysplasia.

Methods: A literature review querying the U.S. National Library of Medicine (PubMed/MEDLINE), EMBASE, SCOPUS, and Cochrane Databases using the key words (“Femoroacetabular Impingement” OR “Hip Dysplasia”) AND (((((“Pelvic Tilt”) OR (Joint Contact) OR (Kinetics) OR (“Pelvic Incidence”) OR (Lumbar Lordosis)))). 14 studies were included in the review with methodological quality evaluated through the Methodological Index for Non-Randomized Studies (MINORS) and Risk of Bias in Non-Randomized Studies - of Interventions (ROBINS-I) criteria.

Results: There were 474 total patients (577 hips) in the 14 studies reviewed. Two studies focused on hip joint contact forces and femoral head coverage in acetabular dysplasia. These found posterior pelvic tilt was associated with decreased hip joint contact area, increased joint contact pressure, and decreased femoral head coverage in dysplastic and borderline dysplastic populations compared to controls. 12 studies evaluated range of hip motion in FAI populations undergoing different functional maneuvers. FAI patients were shown to have decreased pelvic mobility compared to control populations with posterior pelvic tilt, increasing hip range of motion to impingement on supine testing and biomechanical modeling. With dynamic maneuvers FAI patients had decreased pelvic mobility with decreased posterior pelvic tilt compared to patients without FAI.

Conclusions: Hip joint stress is increased with posterior pelvic tilt in dysplastic patients, while increasing posterior pelvic tilt increases hip range of motion to impingement in patients with FAI. During weightbearing exercises, the ability for FAI patients to posteriorly tilt the pelvis is restricted compared to a control population.